How to treat Gynecomastia?!


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How to treat Gynecomastia?


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Treatment of Gynecomastia
Choices of treatment for gynecomastia depend on several factors.

The first is the cause of the disorder. If the gynecomastia is drug-induced, discontinuance of the agent may be all that is needed.

If it is pubertal, watchful waiting is in order, since in most patients the condition will resolve spontaneously.

Gynecomastia due to hyperthyroidism, acute hepatic disorders, or a recent onset of hypogonadism may remit in response to therapy for the underlying disorder.

The second consideration is whether the gynecomastia is an incidental finding, detected only by the physician, or is brought to the attention of the physician by the patient himself. Mild asymptomatic gynecomastia detected only through physical examination requires no therapy other than treatment of the underlying cause.


A third factor to consider is the length of time the gynecomastia has been present. A number of histologic studies have shown that gynecomastia present for less than six months usually demonstrates an active, or florid, histologic picture, characterized by marked ductal epithelial hyperplasia, proliferation of the periductal mesenchymal tissue, and periductal edema.


In general, the indications for treatment include: marked pain and tenderness, severe embarrassment or emotional disturbance. The most uniformly effective therapy at any stage is surgical removal of the glandular tissue through a periareolar incision. In patients with a large amount of adipose tissue in the subglandular area, suction-assisted lipectomy may be performed at the time of surgery to improve the cosmetic results.




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