GYNECOMASTIA  PINCH TEST

GYNECOMASTIA PINCH TEST

Gynecomastia and the pinch test

Self-exam for diagnosis for gynecomastia

 

Gynecomastia is also known as “man boobs” or “moobs.” This is a breast disorder that results in a male developing a female-like breast. However, not all cases of males who are having man boobs are a result of a breast disorder as it can also be a result of being overweight. A test called the gynecomastia pinch test can reveal if it is gynecomastia or not. This article will discuss everything about gynecomastia and the pinch test to help males who go through this condition. It can help them decide whether to take a male breast reduction surgery to resolve this matter.

What is Gynecomastia?

The term gynecomastia came from the two Greek words gynec and mastos, which translates into “female-like breast.” This condition manifests when the breast tissue enlarges because of a hormonal imbalance. This imbalance happens when the testosterone levels decrease while the estrogen levels increase. Factors that cause this hormonal imbalance include:

  • Other medical conditions
  • Age 
  • Genetics
  • Massive weight loss
  • Drug use
  • Anabolic steroids abuse

 

Furthermore, this condition may be one-sided or may affect both breasts. Also, since several factors can cause it, the specific cause can remain unknown. 

 

What are the Symptoms of Gynecomastia?

Gynecomastia can occur in adolescents and adults and can have varying severity. Regardless of the severity, here are the common symptoms of gynecomastia:

  • Painful or swollen breasts
  • Breast tenderness
  • The appearance of movable tissue beneath the nipple
  • A bloody discharge from the nipple 
  • Secretion of fluid similar to breast milk 
  • Itchiness in the nipple and underarm
  • Sudden feelings of being unwell
  • Mood swings and changes in sex drive

Take note that if the male experiences no other symptoms aside from swelling and the breast tissue is fatty, this case is pseudo-gynecomastia.

If the patient is exhibiting symptoms of true gynecomastia, its severity can be assessed using a four-grade categorization.

  • Grade 1 in which the breast enlargement is minor and very unnoticeable. There is slight swelling, but there is no presence of excess skin.
  • Grade 2 in which the enlargement of the breast is moderate and unnoticeable when wearing loose clothing. There is no presence of excess skin.
  • Grade 3 in which the breast enlargement is moderate to severe and is highly noticeable. The swelling may become severe, and there is a presence of excess skin.
  • Grade 4 in which the breast enlargement is significant and severe. There is substantial excess skin and gives the male a feminine breast appearance.

 

gynecomastia before and after

Gynecomastia before and after photo

Gynecomastia and the Pinch Test: How Gynecomastia is Diagnosed

If the male is experiencing breast enlargement along with other symptoms, it is wise to visit the doctor right away for an accurate diagnosis.

To diagnose the condition, first, the medical history of the patient will be reviewed. The doctor will examine if the gynecomastia is caused by physiologic factors or is drug-induced, which is primarily caused by anabolic steroids.

A physical exam called the pinch test is also conducted to find out if the condition is true gynecomastia or pseudo gynecomastia. The patient is asked to lie down on a supine position. The doctor will then use his forefinger and thumb to examine the breast tissue. If the doctor feels a rubbery or firm mass of disk-shaped tissue beneath the nipple, then the condition is true gynecomastia. If no such tissue exists, then it is pseudo-gynecomastia.

Other tests that can be done to obtain a more accurate diagnosis may include:

  • imaging tests using a mammogram to obtain a radiologic picture of the breast tissue;
  • endocrine hormone tests to assess the levels and balance of the hormones; and
  • blood tests to assess kidney, liver, and thyroid function, which can help determine the condition’s underlying cause.

 

gynecomastia before and after photo

Gynecomastia before and after photo

How is Gynecomastia Treated? How is Male Breast Reduction Surgery Performed?

The best treatment option for gynecomastia is surgery, as it is a permanent solution. When the patient undergoes the male breast reduction surgery, the breast tissue will never return. Depending on the severity, the methods of male breast reduction surgery vary.

 

  • Breast Gland Excision with Liposuction. This is the standard procedure. It is best for patients whose condition is not yet severe (Grade 1 and 2). Also, this is regarded as the most successful way of performing male breast reduction surgery. An excision is made on the breast gland while having fat removed from the chest, and this can successfully remove the breast tissue while contouring the chest area. 
  • Two-Stage Procedure. This is the procedure recommended for patients on the Grade 3 classification. As its title implies, there are two stages for this procedure. First is the standard procedure. The second stage is called peri-areolar lift, which is done after 4 to 6 months to let the blood supply re-establish on the nipple-areola. In this stage is the skin reduction done by making an incision around the entire areola, followed by a second larger incision, which makes the tissue between the incision doughnut-shaped. The tissue is then removed, and the incisions are closed.
gynecomastia before and after, free nipple double incision mastectomy

Free nipple double incision mastectomy. before and after.

  • Double Incision Mastectomy. This is the procedure recommended for some patients on the Grade 3 and all on the Grade 4 classification. At the beginning of the procedure, the nipple-areola complex is completely removed before the incisions. The incision is larger as it extends from the breast fold up to the armpit, and it may still be larger depending on the size of the redundant tissue. Once the tissue is dissected off, the table is raised to have the patient in a sitting position to inspect the effects of gravity and how much is the proper amount of skin to make a tight and contoured chest. The nipple-areola complex position is also reviewed to make sure that it is well balanced and aesthetically correct.

 

Conclusion

Having feminine-like breasts is embarrassing and can greatly affect the male’s psychological health, emotional health, and social well-being. Luckily, gynecomastia can be accurately diagnosed using the pinch test combined with other tests. Furthermore, surgery is available no matter how severe the condition is, and all are proven to be successful and effective. You can read more about gynecomastia and the pinch test here: https://www.gynecomastia.org/

 

 

 

 

References:

Swerdloff RS, Ng CM. Gynecomastia: Etiology, Diagnosis, and Treatment. . In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext . South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279105/

 

Cuhaci, N., Polat, S. B., Evranos, B., Ersoy, R., & Cakir, B. (2014). Gynecomastia: Clinical evaluation and management. Indian journal of endocrinology and metabolism, 18(2), 150–158. https://doi.org/10.4103/2230-8210.129104

 

Vandeven HA, Pensler JM. Gynecomastia. . In: StatPearls . Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430812/

 

At What Age Can a Teen Get  Gynecomastia Revision Surgery?

At What Age Can a Teen Get  Gynecomastia Revision Surgery?

Gynecomastia Correction

Gynecomastia before and After Puffy Nipples Eliminated

At What Age Can a Teen Get  Gynecomastia Revision Surgery?

 

Gynecomastia, often referred to derisively as ‘man-boobs’, is endemic in the United States. While gynecomastia can be associated with excess body mass and obesity, many males I see for gynecomastia reduction surgery are not overweight, but simply have experienced the spontaneous proliferation of fibrous breast tissue on one or both sides of their chest, for reasons that medical science currently cannot fully explain. This causes many young men to ask, Why Do I Have Gynecomastia?For young men and teens with gynecomastia, the problem can create a vicious cycle of self-consciousness and social withdrawal. With breast area enlargement, a boy gradually becomes insecure about his appearance without a shirt on or even in workout clothing. They begin to avoid social situations in which their chest appearance is obvious (the gym, the pool, pickup games), and sometimes come to avoid sporting activity of any kind. This can potentially damage their psychosocial development and has a profoundly negative effect on their sense of well-being and quality of life. It certainly is possible that some gynecomastia may improve without surgical intervention after a few years, particularly in very young teens. However, if my own sons had gynecomastia that persisted beyond two years, particularly if they are fifteen or over, I would certainly support their decision to go forward with Surgical Treatment for Gynecomastia

Gynecomastia will not go away with diet or exercise, although I have seen young men injure themselves due to excessive workouts, and others put their health at risk by minimizing calories. Glandular tissue cannot be dieted away. if you are a parent with a son who is concerned about gynecomastia, assure him that it is not his fault and support him in any way you can.

Michael Law MD
Board-Certified Plastic Surgeon
Specializing in Gynecomastia Correction Surgery

Gynecomastia Correction Surgery For Teens – How Old Does a Gynecomastia Surgery patient Need to Be?

Gynecomastia, often referred to derisively as ‘man-boobs’, is endemic in the United States. While gynecomastia can be associated with excess body mass and obesity, many males I see for gynecomastia reduction surgery are not overweight, but simply have experienced the spontaneous proliferation of fibrous breast tissue on one or both sides of their chest, for reasons that medical science currently cannot fully explain. Some males have fullness of the overall breast area, while others have exclusively enlarged glands, or puffy nipples. For young men and teens with gynecomastia, the problem can create a vicious cycle of self-consciousness and social withdrawal. With breast area enlargement, a boy gradually becomes insecure about his appearance without a shirt on or even in workout clothing. They begin to avoid social situations in which their chest appearance is obvious (the gym, the pool, pickup games), and sometimes come to avoid sporting activity of any kind. This can potentially damage their psychosocial development and has a profoundly negative effect on their sense of well-being and quality of life. Many young men will wonder, Why Do I Have Gynecomastia? 
It certainly is possible that some gynecomastia may improve without surgical intervention after a few years, particularly in very young teens. However, if my own sons had gynecomastia that persisted beyond two years, particularly if they are fifteen or over, I would certainly support their decision to go forward with this surgery.  
Gynecomastia correction surgery is the only surgery I perform on teens. I hear stories of young men who wear as many as four shirts during the heat of summer to camouflage fullness in their chest that makes them feel self-conscious.  One parent shared with me that her son was selecting colleges based on the school colors. He only wanted to attend a college where the school colors included black, navy or dark green.
I have seen young men work out too hard and injure themselves, hoping that building muscle will be a distraction from gynecomastia. Others reduce calories so much that they risk a health problem. There is no diet, workout program or pill to eliminate gynecomastia. if gynecomastia persists for a year or more, it may be time to consider Surgical Treatment for Gynecomastia  Some parents want the best for their sons’ but they do not realize that gynecomastia is not fat, and that the only proven way to eliminate gynecomastia is with surgical correction.
 
Michael Law MD
Board-Certified Plastic Surgeon
Specializing in Gynecomastia Correction Surgery

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Gynecomastia And Klinefelter Syndrome

Gynecomastia And Klinefelter Syndrome

Gynecomastia And Klinefelter Syndrome: How Are They Related?

Are you familiar with gynecomastia and Klinefelter syndrome? Did you know that both conditions are related to one another? Klinefelter syndrome results from a male’s low testosterone levels, which lead to gynecomastia or the development of large breasts.

 

Testosterone, a natural sex hormone, plays a vital role in the body. It helps control libido, bone solidity, muscle mass and strength, fat distribution, and red blood cell and sperm production in men. Furthermore, it is known to control a man’s physical appearance, mood and drive for sex. When the body hormones including testosterone are out of control, gynecomastia then develops.

 

Both Klinefelter syndrome and gynecomastia are curable. However, dealing with these conditions needs patience and acceptance. Also, it is essential to know and understand each condition’s underlying causes first.

 

What Is Klinefelter Syndrome?

Klinefelter syndrome is a common chromosomal disorder in males caused by a chromosomal abnormality, wherein there is an extra copy in the X chromosome along the Y chromosome. It is a hereditary condition that affects testicular growth that leads to lower testosterone production. 

 

Furthermore, the potential signs of Klinefelter syndrome are loss of facial hair, body loss, swollen breast tissue, and reduced muscle mass. However, not everyone shows the same signs and symptoms.

Klinefelter Syndrome

Kleinfelter and gyneomastia

Kleinfelter Syndrome and gyneomastia

What Is Gynecomastia?

On the other hand, gynecomastia is a condition wherein the amount of breast gland tissue in boys and men increases due to a hormonal imbalance between the estrogen and testosterone. In addition, it affects one or both breasts in various ways.

 

Moreover, this condition is caused by a low reduction of the hormone testosterone in comparison to estrogen. In some cases, it develops when boys reach puberty, and there is a recognizable difference in hormonal activity. This condition needs to be treated, but it may go away on its own for some cases.

 

Furthermore, the signs and symptoms of gynecomastia are breast tenderness, swollen breast tissue, and nipple discharge in one or both breasts. If these symptoms get worse, consult your doctor.

 

Adolescent male with gynecomastia

The Causes Of Gynecomastia And Klinefelter Syndrome

 

The causes of both conditions are as follows:

  • Impairment of cells in the testes that builds testosterone
  • Accidents
  • Swelling or inflammation
  • Testicular cancer
  • Cancer treatments, including radiation and chemotherapy
  • Various diseases affecting a part of the hypothalamus and pituitary of the brain

The Diagnosis For Gynecomastia And Klinefelter Syndrome

 

Gynecomastia

 

In order to diagnose gynecomastia, the doctor will need to review your drug and medical history, along with your medical family tree. In addition, the doctor will have to conduct a physical test to examine your abdomen, genitals, and breast tissues.

 

Moreover, the initial tests to identify the cause of this condition are:

 

  • Blood test; and 
  • Mammograms

 

Further testing may include:

 

  • Computerized tomography (CT) scans;
  • Magnetic resonance imaging (MRI) scans;
  • Testicular ultrasounds; and 
  • Tissue biopsies

 

After these tests, the doctor will make sure if your symptoms are indeed caused by gynecomastia and not by other health conditions.

 

Klinefelter syndrome

 

The doctor will conduct a thorough physical exam and ask specific questions about your symptoms and overall health. It includes examining the genital area and chest, tests for reflexes, and evaluating functions and development.

 

The primary tests for this condition include:

 

  • Hormone testing. It involves urine and blood samples.
  • Chromosome analysis. It is also known as karyotype analysis that verifies Klinefelter syndrome. It involves a blood sample to examine the shape and number of chromosomes.

 

In some cases, Klinefelter syndrome is diagnosed before birth. 

 

The Treatment For Gynecomastia And Klinefelter Syndrome

 

Gynecomastia

 

Gynecomastia is a type of condition that goes away on its own. Hence, it is essential to have a consistent body observation.

 

There are no proven drugs to treat gynecomastia. However, there are various medical treatments available as listed below:

 

  • Testosterone replacement therapy is effective for older men with low testosterone levels but not adequate for normal testosterone levels.
  • Clomiphene is known to treat gynecomastia, which is taken for up to 6 months.
  • Tamoxifen (Nolvadex) is a selective estrogen receptor modulator (SERM) to alleviate gynecomastia’s breast volume. It is used for painful and severe gynecomastia.
  • Danazol is a testosterone derivative that inhibits the testes’ development of estrogen. It prevents the pituitary from secreting LH and FSH, hormones that guide hormones in the sex organs. Furthermore, it is used less than other drugs for gynecomastia.

 

Klinefelter syndrome

 

The treatment for this condition is based on the signs and symptoms of the following:

 

  • Testosterone replacement therapy. It starts at the beginning of puberty to help promote changes that naturally occur during puberty, such as evolving facial and body hair, developing an extensive voice, and increasing muscle mass and sexual desire. Also, it enhances bone density and fracture prevention, as well as behavior and mood.
  • Breast tissue removal. Plastic surgeons remove excess breast tissue that grows swollen breasts for men.
  • Speech and physical therapy. These therapies are intended for males who have speech, language, and muscle weakness problems.
  • Educational evaluation and support. It is helpful for males who have trouble socializing and learning.
  • Fertility treatment. A procedure called Intracytoplasmic Sperm injection (ICSI) is used for low sperm output in men.
  • Psychological counseling. It assists in resolving men’s emotional problems, including coping with infertility and living with the disease during puberty and early adulthood.

 

How Do Klinefelter Syndrome And Gynecomastia Affect Men?

Dealing with Klinefelter syndrome and gynecomastia in men is tough, especially in the puberty and adolescence stage. These conditions cause a grave impact on their lives as it gives them psychological distress and emotional problems. Additionally, men with enlarged breast development develops low self-esteem, anxiety, loneliness, tension, restlessness, humiliation, embarrassment, rejection, and worst, depression that may leading to suicide. That is why it is necessary to provide these patients support, counseling, and treatment to help them cope and recover.

 

Conclusion 

Gynecomastia and Klinefelter syndrome are among the most common conditions among men, particularly as they start aging. Dealing with these diseases is challenging and may cause emotional problems and infertility. The good news is there are various treatment options to choose from. Furthermore, discussing your condition with your doctor is the healthiest way to determine your treatment. You may also consult a therapist regarding your disease and other concerns. Just remember that you are not the only one who can cope up with those conditions. Talk to a group of men who have gynecomastia to help you cope with these disorders.

 

If you want to know more about Klinefelter syndrome and gynecomastia, do visit this site https://www.gynecomastia.org/.

 

References:

 

    1. Enlarged Breasts in Men. (2019, October 2). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/gynecomastia/diagnosis-treatment/drc-20351799
    2. Singer-Granick, C., Reisler, T., & Granick, M. (2015, December 16). Gynecomsatia and Klinefelter Syndrome. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684628/#:~:text=Klinefelter%20syndrome%20is%20usually%20diagnosed,decreased%20testosterone%20to%20estrad

 

Blog: How Much Does Gynecomastia Surgery Cost

Blog: How Much Does Gynecomastia Surgery Cost

How Much Does Gynecomastia Cost?

If you are struggling with the presence of fatty tissue in the chest, often referred to as “man boobs”, you might be considering gynecomastia surgery. After all, gynecomastia surgery offers permanent results that can eliminate gynecomastia symptoms when diet and exercise fail to produce the desired results. Yet, there’s always one thing between a patient and making their cosmetic goals a reality: the cost of treatment. While gynecomastia can range in price from around $5,975 to around $8,900, we’ll explain where you can expect your treatment to fall within this range, and how you can make it more affordable.

How Much Will My Gynecomastia Surgery Cost?

Gynecomastia in Plano, TXAs mentioned above, you can expect your gynecomastia surgery to cost roughly between $5,975 and $8,900. However, you may be wondering what determines your exact treatment cost, and where you’ll fall within that range. The truth is, it can be difficult to pinpoint the exact cost of a gynecomastia surgery without discussing the procedure in-detail. This is because each patient’s gynecomastia experience will be highly unique, and as such, each treatment requires a uniquely personalized approach. Generally, the cost of treatment will correlate with the extent of surgery required to produce the desired results. Patients with minor gynecomastia symptoms can expect a treatment cost on the lower end of the range mentioned above, while patients with more significant symptoms might expect a cost on the higher end of that range.

How Can I Make Gynecomastia Surgery More Affordable?

Fortunately, there is an easy solution for making gynecomastia surgery more affordable. At the Plastic & Cosmetic Surgery Center of Texas, we are proud to offer financing options to patients interested in gynecomastia surgery. With financing options, patients can access a more affordable treatment by dividing the cost of their treatment into monthly payments that better align with their budget. This can be particularly helpful for cosmetic procedures like gynecomastia, which are not typically covered by health insurance providers. Our practice allows patients to take advantage of a number of financing options, including CareCredit®, American Healthcare Lending and United Medical Credit. These options make paying for gynecomastia surgery as easy as using a credit card, and many offer low or no-interest payments to qualified individuals.