Man Boobs that can't be Worked Away

What is Gynaecomastia?

Commonly known as Man Boobs, Gynaecomastia is a medical condition that results in the swelling of the breast tissues.  Men mainly produce the male hormone testosterone with little amounts of the female hormone oestrogen on the side. When there is a hormonal imbalance, a larger quantity of oestrogen is produced which leads to an increased amount of breast tissue formation in men[1] . Though not a serious problem, it may still be hard to deal with. Physically, patients may feel pain in the breast. Psychologically, it may take a toll on their self-confidence.  

What are the causes? 

Hormonal imbalances leading to a larger relative amount of oestrogen being produced is usually the main culprit leading to Gynaecomastia. However, there are many factors which may lead to this increase in oestrogen levels. 

Physiological[2]

There are various stages throughout a Man’s life where natural changes in the body lead to an increase in the female hormone.

In Infants:
Up to 90% of baby boys are born with enlarged breast. This is due to the lingering effects of oestrogen produced from their mother while they were developing in the womb. This should go away within 2-3 weeks of birth.

In Adolescents:
At least 1/2 of adolescent boys will experience some form of breast enlargement during puberty. This is the result of changes in hormone levels and in most cases, a spike in oestrogen levels. However, this issue should resolve itself within 6 months to 2 years after the commencement of puberty. 

In Adults[3]
At least 3 out of 10 men aged over 50 will experience Gynaecomastia as they age. This is largely due to falling testosterone production levels. This would lead to a comparative increase in existing oestrogen levels which will manifest in the enlargement of breast tissues. This, unfortunately, does not go away. 

Non-Physiological[4]

Other factors such as lifestyle, drugs and existing health conditions may also lead to the development of Man Boobs. 

1. Lifestyle
The way the patient leads his life may contribute to the development of Gynaecomastia. Poor diet resulting in inadequate nutrients for hormone production on top of other poor habits (i.e. lack of exercise) may lead to worsening of the condition. 

2. Drugs 
Certain medications and drugs may also cause Gynaecomastia. 
-    Anabolic steroids that are taken for sports performance and bodybuilding
-    Finasteride (i.e. Proscar®, Propecia®) for enlarged prostate
-    Diazepam (i.e. Valium®) for anxiety
-    Ketoconazole (Nizoral®) for fungal infections
-    Street drugs (i.e. Cocaine, Heroin, Marijuana) and Alcohol 

3. Health conditions 
Other existing health conditions may also lead to hormonal imbalances.
-    Liver Disease 
-    Hyperthyroidism 
-    Hypogonadism 
-    Kidney Failure 
-    Tumours in the testicles or adrenal glands. 

What can you do about it? 

There is a common misconception[5]  that only obese men are afflicted with Gynaecomastia. While it is true that excess fat results in more prominent looking breast, it is not the root cause of the problem. One must remember that it is the development of unwanted breast tissue due to hormonal imbalances. Hence, though exercise may be of some help to eliminate excess fats, it does little to deal with the excess breast tissues. 

There are also a wide array of services out there promising to rid one of such an affliction. These range from fat-freezing machines to creams and pills. Unfortunately, none of these has been medically proven to permanently solve the condition of Gynecomastia.

Gynaecomastia Removal Surgery

A more reliable way of tackling this problem would be to go through a surgical route. 
When consulting with a doctor, he will first ask you about your medical history and your current medicine consumption. He will then check if your breast tissue if the enlargement is due to Gynaecomastia or any other conditions. If the cause is due to medication, he would advise you to stop taking the medication in question. However, if he determines that the best solution would be through breast removal surgery, he will assess the degree[6]  of Gynaecomastia using the following framework.   
-    Grade 1: Small enlargement, but without excess skin over the chest 
-    Grade 2: Moderate enlargement, but without excess skin over the chest
-    Grade 3: Moderate enlargement with excess skin over the chest 
-    Grade 4: Marked enlargement with excess skin over the chest

He would then remove the excess tissue and skin where necessary. This may be paired with liposuction of excess fats around the area to achieve optimal results. This is usually performed as an outpatient procedure and patients typically return to work within one week of the surgery[7]. Patients can return to exercise after a few weeks. 

As the breast tissues are removed, the condition will be permanently solved, and chances or recurrence is slim to none. 

In Conclusion 

Man Boobs can be a particularly difficult problem to deal with having both a psychological and physical impact on an individual. Additionally, it can be even more frustrating to a perfectly healthy and active individual as he will find it extremely difficult to remove them through exercise alone. However, with the correct medical help, this bane can be permanently eliminated leaving the individual feeling more comfortable and confident with his body.   
 

1. https://www.ncbi.nlm.nih.gov/pubmed/27145756
2. https://www.aafp.org/afp/2012/0401/p716.html#ref-list-1
3. https://www.sciencedirect.com/topics/medicine-and-dentistry/gynecomastia
4. https://www.hormone.org/diseases-and-conditions/gynecomastia
5. https://www.bitarinstitute.com/myths-facts-gynecomastia/
6. https://www.business-standard.com/article/health/gynecomastia-alert-do-s-and-don-ts-before-male-breast-reduction-surgery-118100300172_1.html
7. https://www.americanboardcosmeticsurgery.org/procedure-learning-center/body/gynecomastia-surgery-guide/

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