Gynecomastia by Bruce J. Nadler M.D.
Gynecomastia,
or "bitch tits," is a benign enlargement of the male breast tissue.
"Doctor, I have bitch tits. Am I f***ed?" These are the words
that a young bodybuilder used to introduce himself. He went on to describe
how he followed a cycle of anabolic steroids and then afterward noticed
a swelling of his chest that he thought was the muscle growing. It soon
became tender and progressed to a sizable mass of tissue, to the point where
he was embarrassed to take off his shirt and show the physique he'd worked
so hard to build. Dieting and building up his pecs only made the problem
worse. He couldn't even hug his girlfriend without discomfort.
Gynecomastia, or "bitch tits," as it's called, is a benign
enlargement of the male breast tissue. The term comes from the Greek words
gyne meaning "woman" and mastos meaning "breast.
It can occur naturally or as the result of certain substances being in
the system. Historical writings and artifacts show that gynecomastia is
an ancient problem, as evidenced by statues of Pharaoh Seti I that have
enlarged breasts. Aristotle reported encountering the problem, and the earliest
description of the surgical removal of gynecomastia is found in the writings
of Paulus 0f Aegineta, who lived from 636 to 690 A.D.
The incidence of naturally occurring gynecomastia is somewhere between
32 and 65 percent of reported cases. It may be familial, and in that case
it usually occurs at puberty due to hormonal shifts. While several drugs
have been linked to this condition, including marijuana, anabolic steroids
have been found to be the leading cause. These synthetic derivatives of
testosterone trigger a variety of other side effects as well.
Gynecomastia occurs in steroid users because the male hormones they take
undergo a process called aromatization, which occurs in varying degrees
in different substances -- Anadrol and testosterone being the most aromatized.
This process changes the configuration of the male steroid molecule to
that of estradiol, a feminizing hormone. Those who have tissue sensitivity
for this condition will begin to develop breasts.
Fortunately, gynecomastia is correctable with surgery, but be aware that
so-called blocking agents like Nolvadex will not reverse it once it has
occurred.
Being a competitive bodybuilder as well as a plastic surgeon, I have
developed corrective techniques that leave small, unnoticeable scars and
allow the patient to quickly return to training. The chest looks normal
at rest and when the athlete is posing. It's not necessary to have large,
noticeable scars, indentations or deformities.
The procedure can be done on an outpatient basis. A small incision is
made at the border of the nipple complex, and the glandular tissue is carefully
removed. Liposuction is then used to contour the chest and increase muscle
definition. The patient wears an elastic vest for several weeks to control
healing, and modified exercise routines are possible after two weeks, with
a full return to training in four to six weeks. The entire procedure may
be covered by your health insurance.
I've treated athletes from around the globe and recently presented my
work at an international teaching conference. Those of my patients who are
competitive bodybuilders return to competition with confidence. I want all
of my patients to be able to take their shirts off without feeling self-conscious.
Editor's note:
Call Dr. Bruce Nadler's office toll free at: 1 800-445-0505 or 1-516-724-6005
if you are dialing internationally to set up a free personal or telephone
consultation. You can also email Dr. Nadler at:
brucej@drnadler.com
