Gynaecomastia is basically an enlargement of the breast tissue in men. So how do you differentiate if it is a real gynaecomastia or something which is called pseudo gynaecomastia. Real gynaecomastia or the classical gynaecomastia as that is mentioned in our medical literature occurs only in teenagers and it is usually there is a hormonal background to it and usually occurs during the adolescence when the hormonal changes are occurring and the children are growing, in the teenagers. So because of the hormonal imbalance, they have the glands which grow very prominently and they grow as they are growing and that is what causes embarrassment to the kids because they are going to school, they can’t wear t-shirts, they can’t go swimming, they can’t go out into public without the shirts on and so that is painful. This is true gynaecomastia. But true gynaecomastia, the incidene is very low, it is only about 2%.But we get something called as pseudo gynaecomastia which most of the people have, most of the men have and that is the gynaecomastia that is most commonly people come to get the treatment done. That is basically during puberty, your glands are enlarging because of the hormonal changes which occur and usually about 23 – 24 years, the gland should involute and go back to normal, which doesn’t happen. Once that stays on into adulthood, that is when they come in for the treatment and usually what happens is there is some fat collection around the glands and both of them add to it and that is what causes gynaecomastia, which is the pseudo gynaecomastia or the false gynaecomastia. How do we treat it? Usually because this has happened over during your hormonal changes which are happened in adolescence, it just tends to stay there. If it has to go, it will go. If not it just stays there.it doesn’t cause any problems to you. It is just a cosmetic problem. It is just a source of embarrassment when you go out into public or when you go to the beach or when you go to the swimming pool or the gym, where you have to take off your shirt and they show up. The treatment, lot of people go to the gym and they try to work out, I suggest them not to do any chest exercises because the gland and the fat around the gland is sitting on top of the muscle. The more chest exercises you do, the muscle becomes warmer and it pushes the gland and makes it even more obvious. So if anybody is asking you to do exercise for gynaecomastia, just do aerobics, exercises to burn the fat. Don’t do chest exercises which will to help and they will make it more prominent. When you come to the treatment of gynaecomastia, the treatment sadly is only surgical. You can either leave it alone or you have to remove the gland as well as the fat around it. Nowadays we do the minimally invasive treatment which is basically the liposuction from the same we give a half centimeter cut from where the whole gland is removed and the fat is removed and is given a smooth appearance so that it merges with your muscle and it doesn’t give you the odd look like a breast or a pointed look, where you wear a t-shirt, it is seen. Some people try and remove only the gland. If you remove only the gland, what you end up with is something called a saucered deformity where there is a depression where the gland was and the surrounding area there is a fat collection. So best is you have to deal with the fat as well as the gland and both have to be done at the same sitting so that to have a smooth uniform look and immediately after the surgery within a week you can start with your exercises so that you can build up your gland and the excess skin which is taken care of by the, as you build up your muscle, the skin is taken care of and it takes care of your problem once and for all and it is a permanent solution. Once you do the surgery, it doesn’t come back because you are not going through the old phase and the gland is also removed.

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