Gynecomastia, defined as the excessive growth of breast tissue in men, is more common than is generally believed. While this condition may appear temporarily, particularly during adolescence, in some men it becomes permanent, leading not only to aesthetic concerns but also to a loss of self-confidence and shyness in social settings.

Gynecomastia presents as a significant issue that can negatively affect a person’s quality of life and body image. Dr. Güllü Korkmaz, an Aesthetic, Plastic and Reconstructive Surgeon at Medline Adana Hospital, emphasised the importance of tailoring treatment to the individual, stating that this condition must be assessed not only in terms of appearance but also in relation to the person’s physical and psychological expectations.

Gynecomastia is a common condition

Gynecomastia is a fairly common but treatable condition. It is therefore important not to underestimate the aesthetic or psychological distress experienced by the individual and to seek specialist assessment when necessary. In this assessment, the cause of the enlargement must first be identified, and a suitable treatment plan devised accordingly.

Hormonal balance plays a role

One of the main causes of gynaecomastia is a shift in the balance between oestrogen and testosterone. In addition to hormonal changes during puberty, excess weight, certain medications, hormonal disorders, and thyroid, liver and kidney diseases can also lead to this condition. In adults, cases that are newly onset, rapidly progressing, unilateral or presenting as a firm lump must always be assessed by a physician.

Not all enlargement is gynaecomastia

Enlargement of the breast area does not always indicate gynaecomastia. In gynaecomastia, the breast glandular tissue enlarges. An increase in fatty tissue due to excess weight, however, is referred to as ‘pseudo-gynaecomastia’. Distinguishing between these two conditions is crucial for determining the appropriate treatment.

A detailed assessment is required for diagnosis

During the examination, the patient’s age, when the symptoms began, whether the enlargement is unilateral or bilateral, and any medications being taken are assessed. Where deemed necessary, hormone tests and imaging techniques may also be utilised. Particularly in cases that develop later in adulthood, investigating hormonal imbalances and other possible causes guides the treatment process.

Surgical options are the primary choice for treatment

In many cases observed during adolescence, observation for a certain period may be sufficient. In cases where treatment targeting the underlying cause is required, the relevant health issue is addressed first. Surgical treatment may be applied in cases where the condition is persistent and causes aesthetic or psychological distress to the patient. While liposuction is the preferred option for patients with excess fatty tissue, surgical intervention may be necessary in cases where breast glandular tissue is prominent. In patients where both types of tissue are present, combined methods may be considered.

Different methods may be required if there is excess skin

In more severe cases, excess skin may also be present. In such cases, simply removing the fat and breast tissue may not be sufficient. It may be necessary to remove the excess skin and, in some patients, reposition the nipple-areola complex. The method to be used is determined based on the structure of the breast tissue, the amount of fat, skin elasticity and the degree of enlargement.

The aim is to achieve a natural look

The aim of the treatment is not merely to reduce breast volume. The objective of the surgery is to achieve a balanced appearance in the chest area that is consistent with male anatomy. To this end, it is important to accurately determine which tissue needs to be removed and to what extent, and to select the surgical technique accordingly.