Gynecomastia - a case for the Plastic Surgeon
As attractive breasts may be for men - they do not like to look at the feminine attribute. It is therefore not surprising that the enlarged male breast is a taboo topic. But gynecomastia, the benign enlargement of the male mammary gland, affects more men than often thought. The interest in the DGPRÄC expert chat about gynecomastia was accordingly high. Steffen Handstein answered questions about this topic. The chief physician of the Clinic for Plastic, Reconstructive and Breast Surgery at the Municipal Hospital Görlitz has many years of experience in the field of gynecomastia.
At the core of interest were breasts, which were created in combination with a strong overweight. Salopp also called "beer bosom", these breasts consist only of fatty tissue and are therefore referred to as "pseudogynaecomastia". For removal, liposuction may be sufficient - if necessary. "Often the problem is solved by simply losing weight," advises Dr. Handstein. "If there are still bothersome breasts after that, you can still perform a suction."
In most cases, however, the low masculine male breasts consist of an excess of glandular tissue and fat. But how does this happen? Often hormone fluctuations are the cause of gynecomastia, for example, directly after birth or in old age. During or immediately after puberty, according to a study suffer up to 35 percent of the conspicuous breasts. In most cases, however, the breast attachment disappears by itself.
If the breasts persist, this can be an indication of a disease. "Before informing you about breast surgery, you should first rule out any possible medical conditions that could be the cause of gynecomastia," advises dr. Handstein. Triggers can be either medication, kidney or liver disease, as well as malnutrition or, in rare cases, a cancer. Even taking drugs such as marijuana or taking anabolic steroids to build muscle may be the reasons for gynecomastia. The family doctor or urologist should exclude these triggers first. After that, it makes sense to have an idea with the Plastic Surgeon, who can discuss the possibilities of surgery. This usually requires a differently supported cut, through which the excess glandular tissue is removed.
The question of which "cup size" a male breast is no longer "normal", could not be answered flat rate. "Size varies greatly from patient to patient", explains Dr. med. Handstein. But even if the breasts are not bothersome, a possible underlying disease should be excluded.
Plastic surgeons help with gynecomastia
"More and more men are reaching us, who have problems with their breasts, a veritable odyssey to the operation behind them. Apparently, the patients do not know who is the appropriate contact for breast cancer or gynecomastia, the enlarged male breast," says Univ.-Prof. Dr. Dr. H. c. Raymund E. Horch, President of the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC). "The certified breast centers, which are often used for primary breast cancer treatment in gynecology in Germany, provide women with access to quality-assured therapy. Men understand that going to the gynecologist is rather difficult for understandable reasons. "In both cases, Plastic and Aesthetic Surgeons are the appropriate partners for surgery. As is often the case in plastic and aesthetic surgery, cooperation with other specialists in cancer is fundamental.
Gynecomastia - the female breast at the man. In the run-up to surgical treatment of gynecomastia, possible diseases should be ruled out by the family doctor or urologist. An enlargement of the breast could be caused by diseases of the pituitary gland or the ingestion of medications. "Nobody helps if the cause of gynecomastia remains untreated," explains Prof. Horch. A distinction must be made between gynecomastia, in which the mammary gland and adipose tissue increased, and pseudogynaecomastia, which consisted chiefly of adipose tissue. "In the first case, the mammary gland and excess fat is removed with the scalpel, in pseudogynecomastia, however, depending on the severity of the extraction of the fat is possible," says the plastic and aesthetic surgeon. Any reimbursement of costs must be requested in advance from the statutory health insurance funds. "So far, gynecomastia can not be cured with medication. A reduction is only possible through surgical measures," explains Prof. Horch. It surprised the plastic surgeon that the treatment figures for this procedure remained stable for years, although the obesity increases significantly. For example, plastic surgeons in Germany treated around 4,200 patients with gynecomastia in 2014, and about 4700 in 2012 and 2011 respectively.
"Compared to gynecomastia, male breast cancer is a much rarer phenomenon," reports Prof. Horch. According to the Cancer Information Service, 620 men are diagnosed every year, equivalent to about one percent of all breast cancer patients. "The surgical treatment is very similar to the treatment of gynecomastia. Since the male breast tissue is usually not so pronounced, usually the entire mammary gland is removed here. This procedure, known as 'andromastectomy', usually has a good cosmetic result and ensures that the tumor tissue is actually removed, "explains Prof. Horch. The interdisciplinary cooperation is essential. So could possibly be done oncological treatment. "Specialists in plastic surgery are specially trained for the surgical treatment of diseases of the male breast and as a starting point for those affected a right address."