OMG!...I HAVE BITCH TITS!

bitchtits

OMG!...I have Bitch Tits!

By Frank Monaco

Bitch-Tits, (aka Gyno, Man Boobs, Moobs or the more appropriately called gynecomastia) is a subject often discussed among athletes in the bodybuilding and fitness communities. For the rest of us, “gyno” is an issue that causes insecurity and discomfort and is, therefore, a closely kept secret. Most men aren’t aware of how prevalent an issue  gynecomastia is. You might be surprised to learn that one in four men have some degree of gynecomastia. Men can feel insecure or ashamed of their bodies due to this enlargement of breast tissue that causes their chest to have a feminine appearance. If this describes you or someone you may know, there’s a procedure that can remedy this affliction. 

Dr. Frank Stile, an accomplished cosmetic plastic surgeon in Las Vegas, NV, is one of the most experienced gynecomastia surgeons in the country.  His patients include professional athletes, UFC fighters, boxers, Mr. Olympia competitors and regular guys.

What is Gynecomastia?

Gynecomastia is commonly referred to as “gyno” or “bitch-tits.”  It is the result of enlarged or swollen breast tissue (gland) in men, commonly caused by an imbalance in the male hormone testosterone and the female hormone estrogen.  Gynecomastia isn’t typically dangerous, but it can cause mild pain and discomfort.  Disproportionately increased fat localized to the chest can also cause the appearance of gynecomastia or worsen the appearance of gynecomastia resulting from an enlarged gland. 

Regardless of the cause, affected men universally complain, “it just doesn’t look good.” The most common issue for men/boys with gynecomastia is lowered self-esteem resulting from this enlarged breast tissue. In many cases, patients may be so sensitive about their appearance that they refrain from events or situations in which they have to remove their shirt. These feelings of insecurity are heightened in gym locker-rooms, public pools, the beach when wearing form-fitting shirts and even in intimate encounters.

Gynecomastia surgery is on the rise.

There is an increased awareness of gynecomastia in both the general public and plastic surgery community. This has made it less of a taboo subject for discussion and more “main stream.” In 2011, 19,766 cases of gynecomastia corrective procedures were performed as reported by the American Society of Plastic Surgeons (ASPS)— an 8% rise from 2010.  

In 2015, The ASPS showed that men accounted for more than 40% of breast reduction surgeries performed in the U.S. A total of 27,456 breast reduction surgeries (gynecomastia corrective procedures) were performed on men, representing a 5 percent increase over the previous year and a 35 percent increase since 2000.

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A before and after of one of Dr. Stile’s actual gynecomastia patients - click here to see more

 

What Causes Gynecomastia?

Gynecomastia is caused by an altered ratio of androgens to estrogens resulting in increased estrogen levels. Estrogen acts to increase the size of male breast tissue and is made to appear worse by excess fatty tissue in the breast. The cause of gynecomastia is unknown in the majority of cases, but drug use (pharmaceutical and illicit) are estimated to be the main contributor and cause up to 25% of cases of gynecomastia.

Certain health problems in men such as malnutrition, liver disease, kidney failure or low testosterone production can cause breast growth in men. Drugs and liver disease are the most common causes in adults.

Some of the common medications that are known to cause gynecomastia include:  

Ketoconazole, cimetidine, gonadotropin-releasing hormone analogues, human  growth hormone (HGH), human chorionic gonadotropin (hCG), finasteride, estrogens, and antiandrogens, flutamide, and spironolactone, calcium channel blockers such as verapamil, amlodipine, and nifedipine; risperidone, anabolic steroids, alcohol, marijuana, opioids, and omeprazole— just to name a few.

Anabolic steroid (androgen) use is a very common cause of gyno in the fitness and bodybuilding community.  When patients take anabolic steroids, their body temporarily ceases production of testosterone. This is sometimes called suppression.  When patients abruptly stop using these androgens, it takes a while for their body to produce normal levels of testosterone again.  This lag-time creates an imbalance with more estrogen being produced. The higher levels of estrogen can cause the breast gland to grow, resulting in gynecomastia.

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A before and after of one of Dr. Stile’s actual gynecomastia patients - click here to see more

 

 

How does Dr. Stile Treat Gynecomastia?

Picking the right surgeon to correct your gynecomastia is extremely important. Incorrectly performed procedures can leave patients with noticeable deformities. Many of Dr. Stile’s patients are professional athletes who regularly appear on TV. These athletes can have their reputations adversely affected by the negative associations made between gynecomastia with performance enhancing drug (PED) use. These often incorrect assumptions can be career ending.

Treatment of gynecomastia begins with a thorough history and physical examination of the patient. Important aspects of the physical examination include evaluation of the male breast tissue to evaluate the cause of gynecomastia being fat vs. gland or both.

This is followed by a genital exam and evaluation of testicular development  and an assessment for masses that may raise suspicion for testicular cancer. Younger patients are assessed for proper development of secondary sexual characteristics, such as the amount and distribution of pubic and underarm hair. Gynecomastia usually involves both breasts but may occur unilaterally (one side) as well. 

A careful review of the medications or illegal substances patients take may reveal the root cause of gynecomastia.  In addition, blood work is also performed to find the underlying cause of gynecomastia. Lab tests include liver function tests, renal (kidney) function tests and thyroid levels. 

Sex hormones such as Serum beta-human chorionic gonadotropin (B-Hcg), Serum testosterone levels (free and total), estradiol, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) may also be evaluated to determine if hypogonadism (under-developed testes) may be the cause of gynecomastia. 

Just like many other conditions, there are different ways in which gynecomastia can be present in males.  True gynecomastia is generally characterized by enlarged glandular tissue whereas pseudo-gynecomastia presents with excess adipose (fatty) tissue.  Most cases are a combination of both. There may also be varying amounts of excess skin present that may need to be addressed during corrective surgery.

The severity of Gynecomastia is graded as follows:

•  Grade I: Minor enlargement, no skin excess

•  Grade II: Moderate enlargement, no skin excess

•  Grade III: Moderate enlargement, skin excess

•  Grade IV: Marked enlargement, skin excess

The choice of a specific treatment to correct this disorder depending on the severity of gynecomastia.

Dr. Stile, a world-renowned board certified cosmetic plastic surgeon, uses an excision of the breast gland in the case of enlarged glandular tissue and liposuction for cases with excess fatty tissue.  Some patients require both gland excision with liposuction contouring to achieve the best result. 

Most commonly the incision is in the lower part of the areola, and each incision is usually no bigger than two centimeters for most patients.  For extreme cases, Dr. Stile will use a male breast lift technique, removing excess skin to achieve optimum, most masculine results for his patients. Most procedures take approximately 90 minutes, but some extreme cases can require three hours of surgery time. Discomfort following this procedure is minimal. Most patients can return to full normal activity at about two weeks after surgery, including exercise.

Where is this surgery performed?

Dr. Stile is the only cosmetic plastic surgeon in Las Vegas who will perform your surgery in his private surgery center.  His facility, Premium Surgical Services Center, is the only dual state and federal certified ambulatory surgical services center in Southern Nevada. This center was designed with only one goal: to provide the highest quality care, comfort, and privacy for all of Dr. Stile’s patients. 

Want to learn more on how you can overcome this disorder?

If you’re interested in scheduling a complimentary gynecomastia consultation, either in-person or via e-mail and phone, contact us via (725) 222-8644 or visit us on the web at drstile.com 

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