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Gynecomastia
Published in Charles Theisler, Adjuvant Medical Care, 2023
Gynecomastia is a benign proliferation of glandular breast tissue in boys or men. Gynecomastia can affect one or both breasts. Shifting hormone levels in puberty or middle age (physiologic gynecomastia), too much alcohol, street drugs (amphetamines, heroin, marijuana, and methadone), and many different classes of prescription medications can cause this condition. A number of medical conditions can also cause this disorder. As a rule, no treatment is required for physiologic gynecomastia1 and many cases of asymptomatic gynecomastia in adults resolve without any treatment in six months to two years.2 Even for symptomatic male breast tissue enlargement, in most cases over time fibrotic tissue replaces the symptomatic proliferation of glandular tissue, meaning that the pain and tenderness will resolve.3
Principles of Heart Failure Pharmacotherapy
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Erika L. Hellenbart, Stephanie Dwyer Kaluzna, Robert J. DiDomenico
MRAs also block androgen and progesterone receptors, which increase the conversion of testosterone to estradiol. Consequently, gynecomastia (breast enlargement and tenderness) can occur, along with impotence and menstrual irregularities. This occurs more frequently with spironolactone, a non-selective MRA structurally like progesterone. Eplerenone is a selective MRA and has a 100- to 1000-fold lower affinity for androgen and progesterone receptors, significantly reducing rates of these adverse effects.23
Endocrine Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Formulated as the citrate salt, it was first reported by the Finland-based company Farmos (the pharmaceutical arm of Finland’s Orion Group), who obtained patent protection in 1983. It is approved in both the US and the UK for the treatment of hormone-dependent metastatic breast cancer in postmenopausal women with ER+ve tumors or those with unknown ER status. It shows equivalent effectiveness to tamoxifen, although the side-effect profile is less favorable. Toremifene has been reported to be more effective that tamoxifen in the treatment of breast pain and has superior effects on bone mineral density and lipid profiles, including cholesterol and triglyceride levels. Like tamoxifen, it also improves symptoms of gynecomastia in men.
Scar versus shape: patient-reported outcome after different surgical approaches to gynecomastia measured by modified BREAST Q®
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Anna Burger, Amelie Sattler, Lisanne Grünherz, Pietro Giovanoli, Nicole Lindenblatt, Ulrich Michael Rieger
Gynecomastia is defined as a benign proliferation of fibroglandular tissue in male patients. Although benign in nature, gynecomastia typically has a huge psychological impact on the affected male [1–5]. There are three peaks in age distribution described [1]. The first peak occurs in the neonatal period due to the maternal hormones flowing in the baby boy’s blood circulation, the second at the time of puberty and the third at the age of 50–80 years [1]. Gynecomastia has multifactorial causes: while it is idiopathic in 25% of cases [6], it can be due to the abuse of drugs and substances, such as anabolics, or relate to malign proliferations, such as testicular or prostate cancer. The life-time prevalence of gynecomastia in the male population varies from 32% to 65% [4]. Gynecomastia is to be distinguished from pseudogynecomastia, where enlargement of the male breast is due to an increased retro areolar accumulation of adipose tissue.
Integrating the Fast-Track surgery concept into the surgical treatment of gynecomastia
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Jinguang He, Jiafei Yang, Tingting Dai, Jiao Wei
With the liposuction plus pull-through technique, the weight of excised fibroglandular tissue per breast ranged from 1 to 50 g in our study. The results were consistent with that of similar techniques combining liposuction with pull-through technique by other groups. Lista and Ahmad previously reported that the weight of excised tissue per breast was between 5 and 70 g using the pull-through technique [15]. However, it should be noted that the cases that were diagnosed as pathologic gynecomastia were excluded in our study. Typically, the fibroglandular component of the breast tends to be more predominant in these cases. Moreover, we also intended to penetrate the dense subareolar area by cannula to remove the infiltrated fat as much as possible and destroyed the architectural integrity of the mass during the liposuction procedure, allowing it to be pulled out in strands. Thus, a less amount of fibroglandular tissue would be left for direct excision. In addition, approximately 5 mm thickness of subareolar fibrous tissue was preserved in the operation to maintain the vascularity of nipple-areolar complex and avoid the central depression deformity. All these factors together may lead to some variations of the fibroglandular tissue amount that was excised among different studies.
Is the transposition of the nipple-areolar complex necessary in Simon grade 2b gynecomastia operations using suction-assisted liposuction?
Published in Journal of Plastic Surgery and Hand Surgery, 2018
Burhan Özalp, Ömer Berköz, Mustafa Aydınol
Gynecomastia is a common, benign disease of the male breast that affects the male population more than originally thought. The prevalence of gynecomastia has been reported as 50%–60% in adolescents, up to 70% in men of 50–69 years of age, and 30%–50% in healthy men [4,13]. Only a few articles from Turkey have reported the distribution of aetiological factors or surgical techniques in gynecomastia patients, but only one article, which was published in 1989, reported that the gynecomastia incidence was 34.6% in Ankara, the capital of Turkey [14]. Our data showed that the gynecomastia prevalence was 34% in 150 men of 18–35 years of age, which is compatible with the gynecomastia prevalence in our country and previous literature [3,4,14,15].