Adipomastia | |
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Other names | Lipomastia, fatty breasts, pseudogynecomastia. |
A male with probable comorbid gynecomastia and pseudogynecomastia | |
Specialty | Plastic surgery |
Symptoms | excess of skin and/or a flat layer of adipose tissue in the breasts without true gynecomastia. [1] |
Causes | Weight loss |
Differential diagnosis | Gynecomastia |
Treatment | Liposuction, surgery. |
Adipomastia, also known colloquially as fatty breasts, [2] is a condition defined as an excess of skin and/or a flat layer of adipose tissue (that doesn't protude like female breasts) in the breasts without true gynecomastia. [1] [3] [4] It is commonly present in men with obesity, and is particularly apparent in men who have undergone massive weight loss. [5] [6] A related/synonymous term is pseudogynecomastia. [7] The condition is different and should be distinguished from gynecomastia ("women's breasts"), which involves female-like protruding fat tissue and/or glandular tissue in a male. [1] [7] The two conditions can usually be distinguished easily by palpation to check for the presence of glandular tissue. [6] [8] Another difference between the conditions is that breast pain/tenderness does not occur in pseudogynecomastia. [5] Sometimes, gynecomastia and pseudogynecomastia are present together; this is related to the fact that fat tissue expresses aromatase, the enzyme responsible for the synthesis of estrogen, and estrogen is produced to a disproportionate extent in men with excessive amounts of fat, resulting in simultaneous glandular enlargement. [5] [9]
Adipomastia can be classified as grade one, two, or three. Grade one is characterized as having minimum excess fat and skin on the chest, as well as limited change in nipple placement and inframammary fold descent. Grade 1a has no lateral excess skin roll, while grade 1b shows lateral chest skin roll. Grade two is classified as a nipple-areola complex and inframammary fold below the optimum inframammary fold, a lateral chest roll, and limited upper abdominal laxity. Grade three is described as a nipple-areola complex and inframammary fold beneath the optimum inframammary fold, lateral chest roll, and substantial upper abdominal laxity. [10]
Ultrasonic and suction-assisted lipectomy, followed by secondary excisional procedures, can be used to treat Grade 1a Adipomastia. Ultrasonic and suction-assisted lipectomy, as well as direct excision of the lateral chest roll, are used to treat grade 1b Adipomastia. Secondary excisional procedures can be used to treat remaining deformities that do not retract properly. [10]
Grade 2 Adipomastia may be managed with a dermoglandular pedicled reconstruction. [10]
Grade 3 Adipomastia is treated with free-nipple grafting due to the degree of resection. [10]
The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues.
A secondary sex characteristic is a physical characteristic of an organism that is related to or derived from its sex, but not directly part of its reproductive system. In humans, these characteristics typically start to appear during puberty. In animals, they can start to appear at sexual maturity. In humans, secondary sex characteristics include enlarged breasts and widened hips of females, facial hair and Adam's apples on males, and pubic hair on both. In non-human animals, secondary sex characteristics include, for example, the manes of male lions, the bright facial and rump coloration of male mandrills, and horns in many goats and antelopes.
Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases, women believed to be at high risk of breast cancer have the operation as a preventive measure. Alternatively, some women can choose to have a wide local excision, also known as a lumpectomy, an operation in which a small volume of breast tissue containing the tumor and a surrounding margin of healthy tissue is removed to conserve the breast. Both mastectomy and lumpectomy are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies, such as chemotherapy, hormonal therapy, or immunotherapy.
The nipple is a raised region of tissue on the surface of the breast from which, in females, milk leaves the breast through the lactiferous ducts to breastfeed an infant. The milk can flow through the nipple passively or it can be ejected by smooth muscle contractions that occur along with the ductal system. Male mammals also have nipples but without the same level of function, and often surrounded by body hair.
Gender-affirming surgery for female-to-male transgender people includes a variety of surgical procedures that alter anatomical traits to provide physical traits more comfortable to the trans man's male identity and functioning.
Reduction mammoplasty is the plastic surgery procedure for reducing the size of large breasts. In a breast reduction surgery for re-establishing a functional bust that is proportionate to the patient's body, the critical corrective consideration is the tissue viability of the nipple–areola complex (NAC), to ensure the functional sensitivity and lactational capability of the breasts. The indications for breast reduction surgery are three-fold – physical, aesthetic, and psychological – the restoration of the bust, of the patient's self-image, and of the patient's mental health.
Paget's disease of the breast is a rare skin change at the nipple nearly always associated with underlying breast cancer. Paget's disease of the breast was first described by Sir James Paget in 1874. The condition is an uncommon disease accounting for 1 to 4% of all breast cancers cases. 92% to 100% of patients with Paget's disease of the breast have an underlying breast cancer.
An inverted nipple is a condition where the nipple, instead of pointing outward, is retracted into the breast. In some cases, the nipple will be temporarily protruded if stimulated. Both women and men can have inverted nipples.
The intermammary cleft, intermammary sulcus, or sulcus intermammarius is a surface feature of males and females that marks the division of the two breasts with the sternum (breastbone) in the middle. The International Federation of Associations of Anatomists (IFAA) uses the terms "sulcus intermammarius" or "intermammary cleft" when referring to the area between the breasts.
Male chest reconstruction refers to any of various surgical procedures to masculinise the chest by removing breast tissue or altering the nipples and areolae. Male chest reconstruction may be performed in cases of gynecomastia and gender dysphoria. Transmasculine people may pursue chest reconstruction, also known as top surgery, as part of transitioning.
Breast hypertrophy is a rare medical condition of the breast connective tissues in which the breasts become excessively large. The condition is often divided based on the severity into two types, macromastia and gigantomastia. Hypertrophy of the breast tissues may be caused by increased histologic sensitivity to certain hormones such as female sex hormones, prolactin, and growth factors. Breast hypertrophy is a benign progressive enlargement, which can occur in both breasts (bilateral) or only in one breast (unilateral). It was first scientifically described in 1648.
Mastopexy is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. In a breast-lift surgery to re-establish an aesthetically proportionate bust for the woman, the critical corrective consideration is the tissue viability of the nipple-areola complex (NAC), to ensure the functional sensitivity of the breasts for lactation and breast-feeding.
Amastia refers to a rare clinical anomaly in which both internal breast tissue and the visible nipple are absent on one or both sides. It affects both men and women. Amastia can be either isolated or comorbid with other syndromes, such as ectodermal dysplasia, Syndactyly and lipoatrophic diabetes. This abnormality can be classified into various types, and each could result from different pathologies. Amastia differs from amazia and athelia. Amazia is the absence of one or both mammary glands but the nipples remain present, and athelia is the absence of one or both nipples, but the mammary gland remains.
Ptosis or sagging of the female breast is a natural consequence of aging. The rate at which a woman's breasts drop and the degree of ptosis depends on many factors. The key factors influencing breast ptosis over a woman's lifetime are cigarette smoking, her number of pregnancies, higher body mass index, larger bra cup size, and significant weight change. Post-menopausal women or people with collagen deficiencies may experience increased ptosis due to a loss of skin elasticity. Many women and medical professionals mistakenly believe that breastfeeding increases sagging. It is also commonly believed that the breast itself offers insufficient support and that wearing a bra prevents sagging, which has not been found to be true.
A DIEP flap is type of breast reconstruction where blood vessels, fat, and skin from the lower belly are relocated to the chest to rebuild breasts after mastectomy. DIEP stands for the deep inferior epigastric perforator artery, which runs through the abdomen. This is a type of autologous reconstruction, meaning one's own tissue is used.
Liposuction, or simply lipo, is a type of fat-removal procedure used in plastic surgery. Evidence does not support an effect on weight beyond a couple of months and does not appear to affect obesity-related problems. In the United States, liposuction is the most common cosmetic surgery.
Tuberous breasts are a result of a congenital abnormality of the breasts which can occur in both men and women, one breast or both. During puberty breast development is stymied and the breasts fail to develop normally and fully. The exact cause of this is as yet unclear; however, a study in 2011 of the cells in the breasts of both males and females with tubular breasts suggested a genetic link in a disorder of collagen deposition. The condition is thought to affect one to five per cent of breast augmentation patients; however, the proportion of the general population affected is unknown as surgery is not always sought.
Wilson-Turner syndrome (WTS), also known as mental retardation X linked syndromic 6 (MRXS6), and mental retardation X linked with gynecomastia and obesity is a congenital condition characterized by intellectual disability and associated with childhood-onset obesity. It is found to be linked to the X chromosome and caused by a mutation in the HDAC8 gene, which is located on the q arm at locus 13.1. Individuals with Wilson–Turner syndrome have a spectrum of physical characteristics including dysmorphic facial features, hypogonadism, and short stature. Females generally have milder phenotypes than males. This disorder affects all demographics equally and is seen in less than one in one million people.
SPAIR is a short-scar breast surgery technique developed by Dennis C. Hammond, assistant professor of surgery at Michigan State University. The technique was designed to allow a better-shaped breast, a limited amount of scarring, and a more accelerated healing process, by eliminating the lateral scar beneath the breast found in conventional breast reduction surgery. The technique is considered to be a good alternative to vertical mammoplasty.
Gynecomastia is the abnormal non-cancerous enlargement of one or both breasts in males due to the growth of breast tissue as a result of a hormone imbalance between estrogens and androgens. Gynecomastia can cause significant psychological distress or unease.