It is important to distinguish adolescent gynecomastia from drug-related
breast development if treatment results are to be lasting. Gynecomastia
induced by the use of marijuana or anabolic steroids can return after
surgery if these drugs are not abandoned. In these instances, patients
are often sufficiently disturbed by the breast growth to cease their
use of the responsible drug.
The mature or elderly male may also suffer from gynecomastia. When severe obesity or liver disease are the cause, surgery on the breast is not usually appropriate. However, some moderately obese men and those on therapy for hormonally-responsive tumors (like prostate cancer) may be very good candidates for surgical intervention.
The treatment of gynecomastia has improved dramatically in recent years. The need for large, potentially disfiguring incisions once used in years past has been eliminated through the combined use of small incisions at the areolar edge and liposuction. Using these techniques, scarring is minimal and the recovery much less involved.
However, it is well to note that there are still cases for which the preferred, minimally invasive approach is not appropriate. Where skin is in-elastic and in frank excess or the nipple-areolar complex needs to be moved a significant distance, larger incisions will be required.
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