Men have most of their breast tissue behind the nipple. Swelling of a male’s breast tissue is called ‘gynaecomastia’. It occurs naturally (physiologically) at three times in a male life: birth (newborn), teens years (adolescence) and after the age of 50. A number of medical cause can result in swelling of this tissue including medication, liver problems, use of anabolic steroids, hormone dysfunction and following prostate cancer hormonal treatment.
Limited swelling requires gentle reassurance that there are no sinister features. More pronounced swelling can impact an individual’s confidence levels and restrict the type of clothing they wear. Some men will wear baggy clothes or even multiple layers of clothing to try and hide the appearance. There may be reluctance to go swimming.
Anti hormonal medication (anti-oestrogen) therapy is not currently licensed for the treatment of this condition but may be considered particularly if the swelling in associated with pain. There are some side effects of the medication that would be discussed.
Surgery to correct gynaecomastia involves removing the breast tissue under the nipple and in some cases doing some liposuction to contour the breast. Scars can be placed in a number of positions – our preference is to use a scar around the nipple area. There are some risks that would need to be considered, including prominent scarring, fluid (seroma) in the space resulting in swelling, recurrence of the problem and causing a dent in the chest. Most males would be asked to where a post-operative vest for up to 6 weeks following surgery.