What is gynecomastia?

The causes of excess breast tissue in men generally include obesity, hormonal factors (excess estrogen), the use of certain medications, and genetic factors. In most cases, however, no specific cause can be identified. During adolescence, approximately one-third of males may experience enlargement in one or both breasts. This condition usually returns to normal within 1–2 years as hormones stabilize. In some cases, however, breast enlargement does not regress and may become permanent. Structurally, two main groups can be mentioned: the type of gynecomastia seen in obese men, characterized by excess fatty tissue, and true gynecomastia, which involves an excess of glandular breast tissue. Of course, there are also mixed types of gynecomastia that result from both obesity and excess breast tissue.

When is it most commonly noticed?

It most commonly appears during adolescence, when sudden hormonal increases can cause growth in breast tissue. Adolescent gynecomastia usually regresses spontaneously. In cases where the condition persists, problems such as avoiding swimming due to poor body image, wearing loose clothing, or avoiding sports activities may arise, causing the young person to withdraw from social life. In cases of breast enlargement, the patient should first consult an endocrinology or internal medicine specialist so that possible underlying diseases can be ruled out through examinations and tests. Not every case of breast enlargement should be dismissed as simply “due to obesity”; it should always be properly evaluated.

How can it be corrected?

Gynecomastia can be corrected surgically. The main principle is the removal of excess fat and breast tissue. If there is a large amount of glandular (secretory) breast tissue and the tissue is firm, excess tissue can be removed surgically using traditional surgical instruments, and minor corrections can be made with liposuction. If the breast volume mainly consists of fatty tissue related to obesity, the deformity can often be corrected with liposuction alone. In cases where both breast tissue and fat tissue are excessive and there is significant enlargement and sagging of the breast, the breast may need to be reshaped by removing excess skin, similar to breast reduction procedures performed in women. In the same operation, the nipple is repositioned upward and the breast tissue is reduced; in other words, a breast reduction procedure is performed to give the patient a more masculine chest appearance.

When can normal life be resumed after the operation?

After the operation, men should wear a compression garment over the chest area where the surgery was performed for at least 3 weeks. The small liposuction openings around the nipple or the surgical incision will be closed with self-dissolving sutures, so there will be no need for stitch removal. There may be some swelling and bruising at the surgical site. Patients can usually return to desk work and daily activities within 3–4 days and may begin taking warm showers. After restricting upper body and arm movements for 2–3 weeks, normal activities can gradually be resumed. All types of sports activities can usually be performed after one month.