In US, UK: Surgery to correct “man-boobs” on the rise
“Being a man and having breasts is as bad as it sounds,” says Steve Beale who endured taunts and cruel
cruelty as he was growing up, all because he developed a condition called gynecomastia—or abnormal growth of male breast tissue.
“My breasts appeared in adolescence, around the time I was expecting mutant superpowers instead. And I got tortured for it at the rugby team changing-rooms at a West Country boys’ grammar,” Beale recalls in the article Why a bloke like me had a boob job, published by The Guardian in November 2003.
“You’ve got tits. Why don’t you wear a bra?” was one of the taunts that prodded Beale to seek the surgical removal of the breasts in 2003.
Doctors say that gynecomastia is a benign condition, but it can cause deep feelings of shame and embarrassment. It can also interfere with intimate relationships.
“Although harmless,” reads one cosmetic surgery site, “the effects can be psychologically and socially devastating,” driving many men to put themselves under the knife.
Eight years after Beale wrote about his surgery, breast reduction for men has become the fastest-growing procedure in the cosmetic industry of both the United Kingdom and the United States.
Figures published by the British Association of Aesthetic Plastic Surgeons (BAAPs) show that operations to correct gynecomastia in men grew by 27.5 percent from 2009 to 2010, while overall male cosmetic surgery grew by only 6.6 percent.
The association’s figures show that these breast reduction operations rose 80 percent from 323 in 2008 to 581 in 2009, even while just five years ago, only 22 men had a breast reduction operation. There is still no data available for 2011.
Because BAAP represents only one in three plastic surgeons, the real number of breast reduction operations done on men in the U.K. in 2010 is likely to exceed 1,000, BAAP says.
“In all, interest in aesthetic surgery appears to remain strong and growing considerably among UK males despite the economic downturn,” BAAPS president Nigel Mercer told the Guardian in 2010.
US demand growing
In the U.S., a recent survey (December 2010) from the American Society for Aesthetic Plastic Surgery (ASAPS) showed that 49 percent of men in that country now say they approve of plastic surgery.
In all, more than 750,000 total cosmetic procedures in male plastic surgery were performed in 2010, an increase of 88% since 1997, ASAPS said.
And the most common procedure is gynecomastia correction, says Dr. Ram Kalus, a plastic surgeon in Charleston, North Carolina. This is followed by eyelid rejuvenation, liposuction, and face and neck lift procedures.
Dr. Kalus is a Fellow of the American College of Surgeons, and a member of the South Carolina Society of Plastic Surgeons, and of both ASAPS and the American Society of Plastic Surgeons (ASPS).
Breast reduction was only the fourth most popular cosmetic procedures done on men in the past years, the ASPS said, coming after nose surgery, eyelid surgery and liposuction. But it was the procedure that grew faster than the others did, even as the demand for nose surgery declined. In 2010, ASPS performed 18,000 breast reduction operations, up six percent from 2009.
“There is greater awareness in men today of a common condition called ‘gynecomastia’ wherein the male breast is enlarged,” Dr. Kalus said.
“More men are seeking this surgery today than ever before and this is certainly true in my practice as well,” he added.
According to Dr. Kallus, this awareness combined with advances in techniques and technology that allow more subtle results and minimal scarring to drive the increased demand for breast reduction.
Pressure created by men’s magazines is partly to blame, a UK surgeon surmised.
Consultant plastic surgeon Dr. Rajiv Grover told the Guardian in 2010 that while the problem of so-called “man-boobs” was not a new one, it had been thrust into prominence by media coverage.
“Many men are feeling the pressure from men’s magazines that weren’t even being published five or six years ago,” he said.
“In addition, they are just realizing that they can get something done about it.”
But Dr. Grover said that in many cases, surgery could be avoided by simple changes to lifestyle.
“Quite a few cases are caused by obesity, and we often say to men to look at their lifestyles before thinking about the scalpel, “he said.
Gynecomastia is a fairly common condition. More than half of all boys develop gynecomastia during puberty, which goes away by itself within a year.
Gynecomastia also is common in elderly men, especially those who are overweight or obese.
Often, the condition is usually temporary and usually benign.
It may be caused by hormonal imbalance, medication with estrogens or steroidal compounds, or failure of the liver to inactivate circulating estrogen, which occurs in alcoholic cirrhosis.
It can be the first sign of a serious disorder such as a testicular tumor.
Less commonly, gynecomastia may be caused by a hormone-secreting tumor of the breast, lung, or other organ. Biopsy may be performed to rule out the presence of cancer.
It is more common, however, in patients with Klinefelter’s syndrome, a genetic disease in men who have an extra X chromosome that causes low testosterone ((male hormone) levels.
In many cases, gynecomastia goes away by itself without treatment.
Other causes include:
• Exposure to anabolic steroid hormones
• Exposure to the estrogen hormone
• Increase in the formation of estrogen
• Lack (deficiency) of testosterone
• Decrease in production of androgen
• Decrease in sensitivity of breast tissue to androgens
• Kidney failure and dialysis
• Radiation treatment of the testicle
Certain medications can promote breast growth. They interact with the natural levels of testosterone and estrogen, and upset the balance in some manner.
Gynecomastia is also a common consequence of estrogen treatment in men with prostate cancer. Drugs that may cause gynecomastia include:
• Hormones (androgens, anabolic steroids, estrogen agonists)
• Antiandrogens or androgen-synthesis inhibitors
• Antibiotics (isoniazid, ketoconazole, metronidazole) and Penicillamine
• Anti-ulcer medications such as cimetidine
• Cancer chemotherapeutics, especially alkylating agents
• Cardiovascular drugs like captopril and digitoxin
• Psychoactive agents like diazepam and tricyclic antidepressants
• Recreational drugs like alcohol and marijuana
• Alcohol and drugs can cause gynecomastia by mimicking estrogen and stimulating androgen production.
• Steroids and other excess androgens are sometimes converted by the body into estrogens and can cause male breast to develop.
Rare causes include:
• Genetic defects
• Overactive thyroid
Breast in men may be a sign of breast cancer—but this is rare. Signs that may suggest breast cancer include:
• One-sided breast growth
• Firm or hard breast lump that feels like it is attached to the tissue
• Skin sore over the breast
• Bloody discharge from the nipple
Men who are concerned about gynecomastia should consult with their doctors.
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