Getting Started with Treatment at 2 Palms Medical Center
1. Introduction
Gynecomastia is a prevalent condition that affects the chest area of men, often leading to diminished self-confidence and self-esteem. Understanding gynecomastia, its causes, and available treatments—including options like gyno bro and gynecomastia gland removal—can empower those affected to seek effective solutions and regain their confidence.
Estimated Incidence of Gynecomastia in Young Men: Gynecomastia is particularly common during adolescence, with a significant number of young men experiencing temporary breast enlargement during puberty.
estimated incidence of gynecomastia in young men
2. What is Gynecomastia?
Gynecomastia refers to the development of breast tissue in males, resulting in the appearance of female-like breasts on a man's chest. This condition can be unilateral (affecting one side) or bilateral (affecting both sides) and may vary in size and firmness. Understanding the gynecomastia anatomy is crucial for effective treatment and management.
a younger man with bilateral gynecomastia more prominent on the left
3. Man Boob Anatomy
Understanding the anatomy of the male chest is crucial in distinguishing gynecomastia from other conditions.
Gynecomastia Glands - Puffy Nipples
Gynecomastia Glands - Puffy Nipples: These are firm glandular tissues located behind the nipple, pushing it outwards. Their presence causes the nipples to appear puffy or pointed as they push outward.
Areola Changes: The enlargement of gynecomastia glands stretches the areola, making it appear lighter. Post-surgery, the removal of these glands allows the skin to retract, resulting in a darker and smaller areolar complex.
notice how the nipple areola complex shrinks and darkens once the glands are gone
Nature of Glands: Gynecomastia glands consist of tough fibrous tissue that cannot be eliminated through liposuction alone and require surgical removal. This process is often referred to as gyno gland removal.
gynecomastia glands - gross specimen.
Pseudo-Gynecomastia
Characterized by stubborn fat deposits in the lower or side chest areas, leading to a breast-like appearance without glandular tissue involvement. This form is typically addressed with puffy nipple surgery or liposuction.
stubborn fat deposits on the lower/side chest
Quick Facts:
First-Line Treatment: Diet and exercise are the primary treatments.
Affected Individuals: Men with normal BMI and good muscle tone may still develop persistent fat deposits in the chest region.
A Combination of Both
surgically removed large gynecomastia gland with some anatomic labels. on close inspection one can see some yellow fat globules surrounding the glandular tissue.
4. Confidence and Self Esteem
The Ideal Male Chest
The ideal male chest is often described as broad-shouldered, symmetrical, with minimal fat, well-developed muscles, and proportionate nipple-areola complexes. Achieving this ideal through treatments like gynecomastia surgery can significantly enhance a man's self-image and confidence.
5. Diagnosing Gynecomastia
Accurate diagnosis is essential to determine the appropriate treatment.
Physical Exam - What are some signs that you may have gynecomastia?
A palpable mass behind the nipple(s)
Pointed or puffy nipples
Increased lower chest volume
Persistent chest enlargement despite weight loss and muscle building
persistent gynecomastia despite significant weight loss and good muscle tone
Imaging Techniques - CT, MRI and Ultrasound
Depending on the quality of the fibrous tissue, we can see it really well on CTs and MRIs.
CT (Computed Tomography): Provides detailed images of fibrous tissue.
CT of the chest with gynecomastia glands labeled
MRI (Magnetic Resonance Imaging): Offers high-resolution images of glandular and fatty tissues.
MRI of the chest with gynecomastia glands, superficial chest fat, pectoralis muscles and the heart labeled
Ultrasound: Useful for assessing the extent of fatty and glandular tissue.
Understanding gynecomastia anatomy through these diagnostic tools helps in planning effective treatments, whether surgical or non-surgical.
6. Causes
Gynecomastia can result from various factors, often related to hormonal imbalances.
Understanding the root cause is essential for selecting the most effective treatment, whether it's Nolvadex gynecomastia therapy or surgical intervention.
What causes gynecomastia? most cases have no identifiable cause because gynecomastia is a naturally occurring phenomena
Genetics Factors - Nature vs Nurture
Most cases of gynecomastia are caused by our natural genetics and physiology. A quarter of cases are associated with medical problems and about one in five are cause by medications/drugs.
The balance of testosterone and estrogen is determined by our genetics and our environment. These hormones have a big impact on our physical appearance
Prevalence
Physiologic Gynecomastia
Gynecomastia is a naturally occurring phenomena. It ebbs and flows in man's lifetime. It peaks during 3 periods of life. Infancy, during puberty and in our senior years. Prevalence rates as reported by Johnson et al:
Infancy: Transient neonatal gynecomastia occurs in 60-90% of newborns.
Puberty: Transient pubertal gynecomastia affects 50-60% of adolescent males.
Senior Years: Age-related gynecomastia can affect up to 70% of older men.
spontaneous regression of gynecomastia from age 14 (a) to age 15.5 (b)
Pathologic Gynecomastia
Gynecomastia can also be caused by medical problems such as:
Testicular dysfunction (gonadal failure)
Kidney dysfunction (renal insufficiency)
Liver dysfunction (cirrhosis)
Thyroid dysfunction
Hormone-secreting tumors
Obesity (more likely to cause pseudo-gynecomastia)
Other conditions like cystic fibrosis and ulcerative colitis
Medication/Drug Induced Gynecomastia
Contribution: Less than 20% of gynecomastia cases are due to medications or drugs.
Common Culprits: A long list of medications, including certain antidepressants, anti-androgens, anabolic steroids, and more, have been identified as potential causes.
medications implicated in causing gynecomastia
7. Non-Surgical Treatment
Non-surgical options focus on reducing fat and addressing hormonal imbalances.
Diet & Exercise
Approach: Maintaining a low body fat percentage combined with high muscle mass can minimize the appearance of gynecomastia.
Effectiveness: Particularly beneficial for pseudo-gynecomastia caused by fat deposits.
Medications
Tamoxifen 10mg. Brand name: Nolvadex
Usage: Primarily used to treat gynecomastia-related breast pain when the enlargement is smaller than 4cm.
Side Effects: Includes blood clots, loss of libido, bone pain, mental fog, and leg cramps.
Before and After: Many patients report noticeable improvements in chest appearance with Nolvadex gyno before and after treatment
8. Surgical Gynecomastia Treatment
Surgery is often the most effective treatment for significant gynecomastia, especially when glandular tissue is involved.
Overview of the 4-Step Approach
Anesthesia:
Procedure: Administer sedative medications to relax the patient, followed by a large volume of anesthetic injected into the superficial chest area.
VASER (Vibration Amplification of Sound Energy at Resonance):
Purpose: Liquefies the fat surrounding the gynecomastia glands and the surrounding chest wall fat as needed.
Liposuction:
Process: Suctions out the liquefied fat, reducing overall chest size.
Surgical Gland Removal:
Technique: Carefully resects the glandular tissue using tools such as a scalpel, scissors, electrocautery, or through blunt dissection. This process is known as gynecomastia gland removal.
Cost of Gynecomastia Surgery
our TOTAL price is $4,000-$6,000
Total Price Range: $4,000 - $6,000
Financing Options: Available through credit card and cash payments.
Insurance Coverage: Typically not covered; however, payment plans are available at 2 Palms Medical Center.
9. Gynecomastia Surgery Recovery
Post-surgery recovery is crucial for optimal results and minimizing complications. Patients are advised to follow their surgeon’s guidelines carefully to ensure proper healing and the best possible outcome.
10. Complications of Gynecomastia Surgery
While gynecomastia surgery is generally safe, potential complications can include:
Infection
Scarring
Asymmetry
Changes in nipple sensation
Hematoma or seroma formation
Discussing these risks with your surgeon can help you make an informed decision.
11. Frequently Asked Questions (FAQs)
What is gynecomastia?
Gynecomastia is the enlargement of male breast tissue, often resulting in a breast-like appearance.
What causes gynecomastia?
It can be caused by hormonal imbalances, genetics, medical conditions, medications, or lifestyle factors.
Is gynecomastia permanent?
It depends on the cause. Physiologic gynecomastia during puberty often resolves on its own, while other causes may require treatment.
What are the treatment options?
Treatments include lifestyle changes, medications like Tamoxifen, and surgical interventions such as liposuction and gland removal.
Is gynecomastia surgery covered by insurance?
Typically, insurance does not cover gynecomastia surgery unless it's deemed medically necessary. Consult with your provider for specific coverage details.
How long is the recovery period after surgery?
Recovery time varies, but most patients can return to normal activities within a few weeks. Full healing may take several months.
Are there any risks associated with gynecomastia surgery?
As with any surgery, risks include infection, scarring, and changes in sensation. Discuss these with your surgeon beforehand.
You've experienced gynecomastia for over 2 years despite maintaining a healthy lifestyle.
You are relatively healthy with no serious medical conditions.
Your BMI is less than 32 unless you have significant muscle mass or have made substantial progress in weight loss.
Schedule a Free Consultation
Contact: Text 956-315-2851 to schedule a free phone or video consultation with Dr. Hersi. Or CLICK HERE to contact us and book an In-Person or Virtual Consultation.
In-Person Consultation: If deemed a candidate, an in-person consultation will be arranged.
Requirements for Surgery
Blood Work
Why do we request require blood work?
Ensures you're not anemic, have no organ or bleeding issues, and provides a baseline for future comparisons.
How much does blood work usually cost?
There are multiple facilities in the RGV that charge less than $40 for 3 labs we require (CBC, CMP, PT/PTT/INR).
In Person Consultation
How long will the appointment last
50 minutes
What will we go through?
Discuss the goals of the surgery.
Pre operative photos (you will receive a copy) and
Check your vital signs (blood pressure, heart rate, etc)
Deposit: ½ the price of surgery
payments can be made by either credit card or cash.
Required to schedule surgical date
Prescriptions
Prescriptions will be sent directly to your preferred local pharmacy.
prescriptions called into your local pharmacy of choice
Anesthesia: Mild sedation and local anesthesia to numb the target area.
Procedure Steps
Access Incisions
VASER & Liposuction
Gland Removal
Embarking on the journey to address gynecomastia can significantly improve your quality of life. Whether you opt for non-surgical treatments like Nolvadex gynecomastia therapy or surgical intervention such as gynecomastia gland removal, consulting with experienced professionals like Dr. Hersi at 2 Palms Medical Center ensures you receive personalized and effective care tailored to your needs. CLICK HERE to contact us and book an In-Person or Virtual Consultation.
.svg){kind=icon}