Swollen breasts in men: UAE hospital develops new procedure for this common disorder

Breast issues among men are more common than many think — and a hospital in Abu Dhabi has come up with a novel procedure to tackle one particular disorder, which is believed to affect more than 50 per cent of all healthy boys and men globally.

Gynecomastia, a condition resulting in enlarged male breast tissue, is a common concern that adversely impacts men's self-image and may lead to depression and anxiety.

Cleveland Clinic Abu Dhabi (CCAD) has developed a new reconstructive procedure to innovatively enhance the surgical outcomes of gynecomastia.

The condition has been reported by 30 per cent of patients seeking care through CCAD’s breast health programme. The hospital, part of the M42 network, treats about 100 cases of gynecomastia each year.

While the condition is itself not a risk factor for breast cancer, every patient is initially screened through imaging, and even biopsies if required, to ensure that the enlarged breast tissue is not malignant. This is crucial since 0.5-1 per cent of breast cancer patients around the world are men.

Causes, treatment of disorder

The condition can occur at different times, including birth and puberty, and is more common in men over 50 years of age.

It is caused by hormonal imbalances, steroid or medication use, obesity, or organ malfunction.

If a medication or other substance is causing breast enlargement, the individual may need to stop using the drug or switch to a different one. If a disease is the cause, the swelling should go away with treatment. If the condition does not resolve within six months or disrupts an individual’s self-confidence, a surgical intervention is the prescribed course of action.

During the surgery, physicians remove excess breast tissue and skin, perform liposuction, and reposition the nipple-areola complex to a more natural position. The removal of the tissue, however, often causes a concave dip in the chest, known as a ‘dished-out appearance’, and may affect the patient’s self-esteem and overall post-surgical outcomes.

Novel technique boosts outcome

Now, CCAD has developed a novel procedure to improve body contouring, overall appearance, and outcomes for patients who have opted for the surgical removal of the enlarged breast tissue.

The innovative technique has been conceptualised and performed by Dr Rafal Iskanderian, staff physician in the comprehensive breast cancer programme at CCAD.

Through the procedure, the thickened mammary fold that forms under the swollen breast is used to augment the pectoralis muscle, the largest muscle in the chest wall.

This prevents the undesirable dished-out appearance after the surgery.

“Traditionally, the anomalous inframammary fold is carefully resected and disposed of, but this can create an abnormal torso image. Our novel technique seeks to avoid the undesired appearance that may result from gynecomastia corrective surgery, and can significantly enable young men opting for the procedure to become confident in their own skin. We have carried out the procedure on 30 patients, and the results are extremely promising and well-received,” Dr Iskanderian said.

The breast health programme provides a thorough clinical assessment for men with gynecomastia. The comprehensive approach includes history, examination, complete blood workup, and imaging tests. The integrated process aims to accurately diagnose hormonal imbalances and rule out potential malignancies associated with gynecomastia.

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