For almost five years Raju (name changed) wouldn’t step out of home without tightly bandaging his chest. Always conscious of his enlarged breasts, he feared being bullied or touched inappropriately. Anxiety led to depression, Raju quit his studies, and then harmed himself. Luckily, his family understood what he was going through and got him treated for depression. Now, after undergoing gynecomastia surgery or breast reduction, Raju has a grip on his life at 24. But doctors say the number of Rajus is on the rise.
Docs See More Cases
Dr Nikhil S Shetty, associate professor in the department of plastic surgery at Mangaluru’s Justice K S Hegde Charitable Hospital, says the number of boys and men coming for treatment has increased by at least half in the last two years. Dr Rajesh Vasu, head of the department and consultant plastic and aesthetic surgeon at CARE Hospitals, Hyderabad, also says that they have observed a 50% increase in gynecomastia cases.
The reason for this sudden rise is not clear, but it could be diet, the pandemic’s sedentary lifestyle, or simply increased awareness about the surgical procedure, or even a backlog of cases from the pandemic years.
The Mental Toll
Dr Shetty says men reporting with gynecomastia (enlarged breasts) are often body-shamed and suffer low self-esteem, and this can have grave consequences. Nerissa Hendricks, counselling psychologist at Fortis Hospital, Bengaluru, says gynecomastia may negatively impact a man’s mental health. “When males notice swollen glandular tissue their initial reaction is anxiety. Insecurities about the solutions available, the potential treatment and results worry them.”
Hendricks also says the fear of being teased leads to “withdrawal from social situations and it slowly impairs a man’s overall health, social functioning, mental health, self-esteem, eating habits and even mental stability.”
Common In Puberty
About half of all boys experience some breast enlargement in their puberty, and 20-30% retain enlarged breasts into adulthood, doctors say. Dr Joseph Thomas, associate professor at the department of plastic surgery in Manipal’s Kasturba Medical College, says men having “excessive fat deposition in the region of the breast is not abnormal but consistent with normal patterns of fat deposition in the body. In fact, this condition is called pseudo-gynecomastia.” He says male breasts can grow for a number of reasons but “cases of true gynecomastia, where there is enlargement of the underlying gland, have not in creased that much “.
While it’s not an alarming larged breasts affects men’s sense medical condition, having enof masculinity, and makes them look for a solution. “All they want is a normal life where they can wear an ordinary T-shirt and post shirtless photos,” says Dr Shetty.
Ram (name changed), who opted for surgery a year ago when he was 20, says, “I felt embarrassed wearing a regular T-shirt and avoided socialising. But after surgery my self-confidence increased and the best part is that I could go home the same day.”
Treatments Galore
Dr Thomas thinks the increasing number of gynecomastia surgeries should not be seen as a negative trend. “It is consistent with the growth of aesthetic surgeries in India, partly a consequence of the increased affluence.”
Patients seeking breast reduction surgery undergo basic psychological evaluation to rule out body dysmorphic issues.
Dr Thomas Joe, plastic surgeon at KMC Hospital, Mangaluru, says each patient is evaluated for treatable or partly reversible causes, and to rule out underlying diseases that may be manifesting as gynecomastia. Milder cases are treated with a minimally invasive procedure like liposuction, while the more advanced cases usually need some removal of breast glandular tissue, he says. Severe cases occasionally need surgical removal of the breast or a body contouring operation.
Dr Vasu says new surgical methods involve a small incision of hardly a centimetre through which all of the breast gland is removed. The scars are barely noticeable. Radiofrequency or laser-assisted liposuction is done for skin shrinkage and body contouring. It is now possible to give a chiselled look to a patient with a normal bodymass index. Surgical complications are rare and patients can get back to their routine in 3-4 weeks, Dr Vasu said.
On Bodybuilding
A subset of men with fatty breasts are bodybuilders who have been taking steroids and health supplements without proper guidance, says Dr Thomas. Their steroid and supplement abuse arises from “irrational expectations and unscientific advice from trainers”. The most important part of the treatment in such cases involves addressing the underlying health issues and stopping the consumption of the suspect supplements or drugs.
