‘Man boobs’ (gynaecomastia) have always threatened the masculinity and machismo of men of all ages but a recent article in The Independent has suggested that breast reduction surgery in young adolescents has surged in the US in the last few years and now is the commonest type of surgery requested by male teenagers with some 6,694 boys and men aged between 13 and 19 undergoing surgery in 2014. These operations can cost anything between 5000 – 15000 US dollars depending in which region the patients live.
Although no doubt the obesity epidemic in the US plays a significant part in all this, oestrogen/testosterone imbalances can occur during puberty and is a common reason for breast buds to develop in slim boys also, particularly just under the nipples. In fact Dr Glasberg, a New York city plastic surgeon stated that the majority of his patients with gynaecomastia had relatively normal BMIs. There has not been a similar explosion in UK as yet with only 200 operations of this type being performed on the NHS in the last 5 years (the Daily Mail reports).
However with more and more men’s glossy magazines depicting ‘perfect Adonis bodies’ appearing on the market, it is likely the demand will rise.
Frequently these embarrassing breast buds completely disappear when puberty is completely over (which may be in the early 20s) but occasionally anti-oestrogen drugs such as those used in treating breast cancer (tamoxifen and Raloxifine) may be necessary and are often very effective.
Gynaecomastia in later life can also occur. It is frequently seen in patients with liver disease, heart failure, following prostatectomy for prostate cancer, or with certain drugs such as digoxin, spironolactone, diuretics and LHRH.
It can also occur in normality particularly in men who have previously had well developed pectoral muscles but who have stopped training.
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