MAN BOOBS or “MOOBS”

This word came as a surprise to me initially when a patient of mine mentioned the term to point out to his problem. But then on doing a search, I found that its the common term used to describe the condition of “Gynecomastia”.

 

This is a condition where in the chest area of the male is more prominent. This is usually seen in the peri pubertal age group, when it starts to develop because of the hormonal changes going on in the body. The condition normally resolves as he grows up into adulthood. But, in a fair percentage of men this involution does not happen and they carry it into adulthood too.

 

Classically, Gynecomastia is referred to “painful enlargement of the breast tissue in a male”, but nowadays enlargement of the chest area, whether painful or not is commonly clubbed under the heading of “Gynecomastia”

 

This condition can be of three types in common terms. It could either purely fat which is seen in obese patients or it could be purely glandular – the classical Gynecomastia. But, most commonly it is a combination of both that is seen. Approximately 80% of patients belong to this category. All these could be without without skin excess.

 

I have had many patients come to me saying that they have been working out in the gym really hard but can't seem to get rid of the bulges in the chest area. The reason is because of the presence of the gland tissue. Another common question I get from these patients is regarding hormonal imbalances. Though in specific conditions it is because of a hormonal imbalance, it is usually not the case. In most cases the cause is not specified.

 

This is one of the few conditions that we as plastic surgeons operate on, even when the patients are young. This is a cause of embarrassment and ridicule among friends for a young adolescent which can lead to significant psychological trauma.

 

Over the years there has been a change in the treatment protocols too. Nowadays the most accepted mode of treatment is a surgical removal of the glandular part along with liposuction of the fatty part. Previously skin excision were common but with increased understanding and with the aim of reducing the ghastly scars on the chest, skin excisions are now limited to patients with severe grades of the condition along with significant skin excess.

 

The surgery is usually done via a cut under the nipple so that the scar merges well with the nipples without leaving behind a stigmata of a surgery. The gland is removed from the same cut and the suction is also done through the same incision Post operatively, the patient is supposed to wear a vest or pressure garment. This will help in skin shrinkage and also aid the healing process. This is worn for a period of @ 3 months. The patient can start routine activities usually very early, including return to the gym and exercises.

Though it is a simple procedure it has to be done by qualified people well versed with the anatomy of the area to reduce the scarring and to address all the problems as well. The most common problems are usually in the healing process which are swelling, pain. Rarely there maybe infections and sometimes the skin excess may remain which has to be dealt with.

 

Many patients come for secondary procedures after being operated elsewhere where a proper excision or suction was not done. Another problem of improper technique is where an excess of tissue is removed leaving a crater deformity or “Saucer deformity” which is much more difficult to correct.

 

But, overall it is a very satisfying procedure for the surgeon as well as the patient, when done properly. The transformation is dramatic and heartwarming especially in youngsters who have been withdrawn and embarrassed because of this and have been watching life from the sidelines.

 

 

Dr.Surindher