Enlargement of the male breast can occur whenever there is an imbalance between the male and female hormones. For example babies are under the influence of their mother’s estrogen when they are born and can display temporary breast enlargement.
At puberty the hormones are not in balance and again enlargement of the breast can occur. It usually regresses when the hormones become readjusted. The enlargement occurs in around 75% of teenagers and regresses completely in 75% of them.
In slightly older males, when testosterone levels start to drop, some enlargement of the breast can appear more frequently as a result of medication intake. There is a whole list of medications that can cause enlargement of the breasts and regular use of marijuana has also been associated with glandular enlargement.
Under microscopic examination it is essentially fat and fibrous bands made out of collagen. There are no glands in general that are found in that tissue.
If upon examination the enlargement is mainly fat, then liposuction can be very helpful. However when there is a fibrous component, than we need to resort to sharp excision. An incision is made in the lower part of the areola at the junction of the skin and the areola. It allows access to the involved tissue so it can be removed.
If the areola is significantly enlarged it can be reduced as well. With technical refinement over the last few years we have limited our incision to the area of the areola – in all circumstances.
The procedure is performed in an outpatient setting under intravenous sedation or general anesthesia. The sutures are self dissolving and if drains have been placed it would be removed once the drainage has ceased.
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