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The term means female like breasts. Abnormally enlarged breasts in men which is not welcome and usually affects their confidence and restrict many men in the clothing they choose to wear or outdoor activities they might want to do. Many who have had this procedure have said to they are just happy to be able to wear normal clothes or to be able to swim in public. Many bodybuilders are embarrassed after using anabolic steroids and constantly see this as an imperfection no matter how good they perceive the rest of their body to be. The embarrassment caused by gynaecomastia can be stressful and even lead to depression. Online support groups are available, talking to friends or family, and counselling are all effective options for coping with gynaecomastia.

How common is it?

It is thought to affect 60-70% of the men. Typically it starts as a little lump under the nipple, usually during puberty. The lump usually goes away with time, but not in all cases. It can be a frightening experience for an adolescent. Gynaecomastia generally occurs due to an abnormality in the ratio of sex hormones. This stimulates the growth of the tissue around the breast. This most commonly occurs in newborns, adolescents and in the old.

A breast lump should always cause some concern. In men breast cancer is very rare (less than 1% and usually in men between the ages 60-70). There are about 300 men diagnosed each year in the UK, compared to around 45,700 cases in women.

Other risk factors are high oestrogen levels, exposure to radiation, a family history of cancer or a recognised breast cancer gene in the family, and a rare genetic condition called Klinefelter's. Gynaecomastia often occurs on both sides, so if a breast lump occurs on only one side it may be more suspicious for cancer. It would be extremely unusual to see male breast cancer on both sides at the same time. In some cases a mammogram or ultrasound may be required. Sometimes a biopsy of the tissue must be done to be sure it isn't cancer.

How is Gynaecomastia treated?

Avoid and stop the use of anabolic steroids. Once serious causes are ruled out or treated, medical treatment is tried (such as stopping problem medication) and if resistant to any other treatment the excessive tissue in most cases can be removed by either liposuction or surgically using local anaesthesia under light sedation. Liposuction may be used if caused by mainly fat tissue or may cut out the excess tissue directly through an incision along the edge of the areola if the tissue is dense. When direct excision is used, a layer of tissue must be left under the nipple to prevent it from dimpling the chest or dying due to loss of blood supply. The combination of two can be very effective. The procedure usually lasts for 1 hour, rarely it may take slightly longer.

What are the risks of the surgery?

Complications such as bleeding, which is very rarely may require drainage of the collection of blood. This is usually prevented by wearing the supplied tight vest. Infections are also very uncommon but taking antibiotics after the procedure usually prevents this. Complications are more common in steroid users due to the high degree of vascularity of the chest wall. The nipple sensation is usually altered after the operation. Depressions or contour irregularities can also occur. In very rare cases the nipple dies due to loss of blood supply. If this happens this has to be removed and a skin graft is used to replace the lost skin. This occurs in extremely rare instances.

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