Gynecomastia can happen when the amount of testosterone in the body drops compared with estrogen. In people assigned male at birth, the body mainly makes the sex hormone testosterone. People with gynecomastia sometimes have pain in their breasts. Enlarged breasts in males are usually harmless, but may cause men to avoid wearing certain clothing or to not want to be seen without a shirt. Ready to stop worrying about your nipples and start feeling confident in your own skin? Nipple reduction men surgery has helped countless men reclaim their confidence and comfort in their own skin. I understand that scarring concerns keep many men from moving forward with nipple reduction men surgery. Book A Consultation With Dr Tarek Bayazid Nipple surgery can be performed on its own but often is combined with some type of Breast Surgery. But it may lead to mental health concerns due to changes in how the chest looks. Or it can be caused by conditions that raise the estrogen level. When present as small, circular, pigmented skin lesions they may resemble moles or other benign skin pigmentation. This condition may present early in childhood, during breast development in adolescence or appear later in adult life. In addition, nipple hypertrophy may lead to chafing and irritation from constant rubbing against clothes, which can cause further discomfort. If a medical condition is causing the problem, your provider will treat that condition.He has been providing cosmetic and reconstructive plastic surgery procedures to thousands of satisfied patients in New Jersey and New York for over 20 years.Gynecomastia is characterized by the enlargement of breast gland tissue in males.Multiple studies have reported a particularly high rate of HIV/AIDS among MTF patients, approaching 20% in some parts of the world, adding unneeded stigma to an already marginalized population.The decrease can be caused by conditions that lower testosterone or block its effects.It is reliably assumed that Kendall Jenner may have opted for non-surgical dermal fillers to make her nipples more prominent.Although most patients self-diagnose and are already aware of the problem before seeking help, the best way to get properly diagnosed is to find a double board-certified surgeon that specializes in gynecomastia.You should be at a stable weight for at least six months before surgery, since significant weight changes can affect your results.As a board-certified plastic surgeon and skilled portrait artist, I bring a distinctive combination of artistic vision and surgical expertise. Understanding the causes and treatments of gynecomastia can help individuals cope with the condition and seek appropriate medical intervention. Substance abuse, including some prescription and recreational drugs, contributes to gynecomastia. For instance, newborn babies and boys during puberty may temporarily have gynecomastia due to maternal hormones and puberty-related hormone changes. Evaluation of current practice Similarly, men also feel self-conscious about their bodies, which can include feeling insecure about the size of their breasts. Once your nipples are numb, the surgeon will make a few tiny horizontally-oriented incisions at the nipple area and remove any extra tissue. Keep in mind that the areola is the pigmented skin around the nipple, while the nipple is the projection in the center of it. Dr. Vij can rectify these conditions by conducting nipple surgery for males with ease. Recreational drugs, illegal drugs and alcohol Prior studies have shown an association between BMI and position of the NAC; suggesting that nipples tend to lateralize with increased BMI (Kasai et al., 2015; Vaucher et al., 2016). Nipple areolar complex (NAC) positioning in men has been studied to a far less extent than in women (Lewin et al., 2016). This implies that on average the NAC was positioned too close together and too high on the chest, compared to cisgender males with similar chest dimensions. The intra- and inter-observer reliability of both the observers were respectively tested by drawing random samples of 10 participants who were tested twice within the same study visit and in a cohort of 10 similar patients. All measurements were performed in the same room, with temperature maintained at 21 degrees to prevent cold-induced skin and nipple contraction. Pigmented areola graft positioned.Fillers can help add projection to the area, giving the nipple a more erect appearance.The incidence of breast malignancies, each with varying degrees of hormone receptor expression, is very high and affects as many as 1 in 9 women during their lifetime (3).Given the elevated levels of “opposite” sex hormones, the physiologic effects of long-term HRT warrant future study.All measurements were performed in the same room, with temperature maintained at 21 degrees to prevent cold-induced skin and nipple contraction.The procedure to enhance the male breast is similar to that done for women.Let me put your mind at ease – the scars from this procedure are typically very minimal and well-hidden.Contrary to popular belief, men don’t have to be overweight to experience gynecomastia.Therefore, most MTF patients use anti-androgen agents such as spironolactone and cyproterone in conjunction with estrogen to achieve even lower testosterone levels.In patients who only need liposuction to correct their enlarged male breasts, return to exercise and work is typically less than one week. Women are not the only ones who want bigger breasts, there are also men who want bigger breasts, the question is can men make their breasts bigger without surgery? All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. It is always best to consult with an experienced board-certified plastic surgeon who is an ASPS member before going all in on nipple filler. Herbs might provide some benefit for breast enlargement, but very little objective evidence exists confirming efficacy of most substances. Surgical methods of breast enhancement are always highly effective and also very dependable for providing the exact results desired by the patient. These individuals also have highly personal desires for breast modification. These people are now trapped in a male body and desire to transition back into female roles. Noogleberry Breast Pump for Men Obesity (excess fat contributes to hormone shifts and physical enlargement) Medications, including antidepressants, prostate cancer drugs, and certain heart medications Contrary to popular belief, men don’t have to be overweight to experience gynecomastia. A follow up to the meta-analysis included 8 articles and described a total of 17 FTM patients with breast cancer (median age at diagnosis 44.5). Family history of breast cancer was reported by seven patients (one BRCA2+) (25). A meta-analysis published in the European Journal of Surgical Oncology in 2018 summarized 18 articles which described a total of 22 breast cancer events (median age of 51.5 at diagnosis) in MTF patients. In older men, age-related hormone shifts can decrease testosterone levels, causing an imbalance with estrogen levels, potentially leading to gynecomastia. The breasts often grow unevenly and may appear as a lump or fatty tissue beneath the nipple. Common complications include bruising, bleeding, fluid collections, contour irregularities, loss of nipple skin, visible scarring, numbness of the nipples, inverted nipples, loose breast skin and asymmetries. For patients who need surgical removal of the excess breast tissue, it can take between two to four weeks to heal enough to tolerate routine activities. In patients who only need liposuction to correct their enlarged male breasts, return to exercise and work is typically less than one week. This can be done through liposuction and/or tissue excision surgery. It can also be the result of previous gynecomastia surgery. Due to these facts, in our nipple hamartomatous lesions, a hormonally driven etiology seems to be the most probable etiology. Moreover, our patient’s nipple lesions can be considered as the nipple-type analogous to the widely known muscular hamartoma of the breast . Men of all the types detailed in the above sections might also desire to undergo breast treatment using purely nonsurgical or even noninvasive methods of care. Finally, men can describe natural born females who transitioned to male roles, are fully satisfied, but still want to improve their chest profile to look more convincingly masculine. Next, the word men might describe natural born males who identify with the female gender and are in various stages of transitioning to become women. All these variables make the proposition of male breast enhancement a very interesting topic for discussion. In essence, enhancement means to improve breasts from the perspective of the person undergoing treatment. Numerous substances, both exogenous and endogenous, can stimulate breast hypertrophy. The fact that many FTM patients still have some or all of their natal internal reproductive organs (i.e., uterus, ovaries and adnexa) even after transition, poses additional questions of how to perform routine gynecologic surveillance. Prostatectomy is not routinely performed in gender-affirming bottom surgery due to the risk of incontinence and other morbidity (87). If you’re seeking exceptional results in male breast augmentation, look no further than Dr Tarek Bayazid. As societal perspectives on the benefits of cosmetic interventions change, the popularity of male breast augmentation has increased. The male breast augmentation trend is on the rise among cosmetic surgeons. As one of the medical tourism hubs, Dubai offers state-of-the-art facilities and experienced surgeons for cosmetic procedures. The cost of male breast augmentation in Dubai varies depending on several factors, including the surgeon’s expertise, the clinic’s reputation, and the type of implant material chosen. A selection of common hyaluronic acid dermal fillers can be utilized in a nipple enhancement procedure. The cost of your nipple enhancement procedure may vary depending on your individual circumstances. Requiring no skin test, it is also a safe, effective option for nipple enhancement. The decrease can be caused by conditions that lower testosterone or block its effects. If it doesn't, medicine or surgery may help. Most often, gynecomastia isn't a serious problem. When you’re already addressing enlarged breast tissue, it makes perfect sense to perfect the nipple proportions simultaneously. The change after nipple reduction men surgery often surprises patients with how significant it feels. This quick outpatient surgery reduces nipple size, projection, or diameter to create a more proportional and masculine chest appearance. Caring for Your Nipples Post-Op This implies that on average the NAC was positioned too close together and too high on the chest, compared to cisgender males with similar chest dimensions.Plastic surgery involves changing or remodeling tissues to restore function, improve appearance or both.In these operations, the incision used to lift the nipples may also serve to achieve changes in circumference and shape of the areola.These tests may include blood tests, liver function tests, hormone studies, urine tests, a mammogram, or a biopsy to check for cancer cells.The breast and nipple may be numb for a short period after the procedure.Three of them describe a technique based on composite NAC grafts, the areola and the nipple are disassembled and separately resized before being grafted 8-10.In case of medium/big size and ptotic breast, free nipple graft technique is the procedure of choice.Maintaining a healthy weight, regular exercise and a balanced diet can help manage gynecomastia. Despite such extensive research on the effects of these hormones in biological females, their effects on transgender patients remains largely unexplored. Interestingly, the use of estrogen without progestin did not significantly increase the risk of breast cancer, even in survivors and patients at a higher baseline risk for breast cancer (15). The Women’s Health Initiative study on estrogen and progestin hormone replacement therapy in post-menopausal women is perhaps one of the most definitive randomized controlled trials of the modern era. Would recommend if you are looking to get a breast reduction. I’m almost 4 months post op on a breast reduction and couldn’t be happier with the results!! But sometimes, it’s your nipple size or lack of projection that’s a problem. Excessively large implants may produce early drooping of the breast. Some stretching of the skin may produce discomfort for 3 to 4 days after surgery. Even in the rare cases where someone isn’t completely satisfied with their scar appearance, revision procedures are available to further improve the results. The 6-12 month mark is when you’ll see the most dramatic improvement, with many scars becoming nearly imperceptible. Most of my patients are pleasantly surprised by how their scars fade over time. Factors like your age, skin type, and how well you follow post-operative care instructions all influence the final appearance. The chevron technique that works so well for men allows me to hide the incision lines right at the base of the nipple where they blend into the natural color transition. This method is minimally invasive and generally offers a shorter recovery period compared to traditional mastectomy procedures.Once your nipples are numb, the surgeon will make a few tiny horizontally-oriented incisions at the nipple area and remove any extra tissue.Breast feeding – As previously mentioned, some corrective nipple surgeries can reduce your potential ability to breastfeed.Gynecomastia can affect one or both breasts, sometimes unevenly.Your goal is to enhance the length of your nipples.During surgery, preserving the nerves and blood vessels that supply the nipples is essential in order to maintain nipple sensation and breastfeeding ability.I have had a lot of experience using a variety of breast creams and enhancement devices.This medical condition, called gynecomastia, often occurs in adolescent boys, or later in middle age. I usually tell patients to listen to their bodies – if something feels uncomfortable, wait a few more days. Walking is great and actually helps with healing, but you’ll want to avoid anything that puts stress on your chest. I always tell my patients that choosing a surgeon who understands the delicate balance between achieving your aesthetic goals and preserving function is crucial. Patients who seek nipple reduction for unusually large nipples, called hypertrophic nipples, are usually concerned about the prominence of the nipples, which can make them too conspicuous or unsightly under clothing. The following are some of the most commonly sought after aesthetic procedures of the nipple and areola. If you want to enjoy nipples that have a better projection, the team at Rowe Plastic Surgery offers successful nipple enhancement surgery. Hormonal imbalances, steroid use, significant weight changes, and gynecomastia can also play a role. Some wear dark shirts with graphics specifically to camouflage nipple protrusion. Many men confuse the two, but they require different surgical approaches. My experience with thousands of breast surgeries gives me unique insight into creating natural, masculine results that last. Most patients are amazed by how quick and easy the recovery is. The tendency of steroid hormones to promote the growth of certain cancers also raises questions about the safety of differing doses and drug combinations. We conclude that the long-term effects of off-label pharmaceutical use for modulation of hormone levels and sexual characteristics in transgender patients have not been well studied. A search of the existing literature focusing on therapeutic regimens and the effects of HRT on breast tissue provided the most current information available for this review. Hormone replacement therapy (HRT) has become a mainstay medical treatment option for management of gender dysphoria in transgender patients of both biologic sexes. Breast feeding – As previously mentioned, some corrective nipple surgeries can reduce your potential ability to breastfeed. What Are My Nipple Injectable Filler Options? They involve the mammary gland and skin excess removal and reshaping with repositioning of the nipple-areola (NAC) complex 1. Chest wall masculinizing surgery represents a general gender reassignment procedure that trans men patients request. This original and simple procedure can aid surgeons with reproducible nipple reconstructions in free nipple graft mastectomy in case of large nipples. It is important that your surgeon perform a proper physical exam of your breasts to confirm gynecomastia and rule out the suspicion for male breast cancer. When patients come in with a complaint of gynecomastia, they usually complain about lumps in their breasts with or without excess fat in the breasts. Breast self-exams usually demonstrate a palpable, tender, firm, mobile, disc-like mound of tissue that is not as hard as breast cancer and is located centrally under the nipple-areolar complex. Membrane estrogen receptors (mERs), which are cell surface G-protein coupled receptors that trigger intracellular signaling pathways rather than directly modifying gene expression, also exist on certain cell types. There, the estrogen receptor complex binds to DNA via highly conserved DNA-binding domains, ultimately inducing changes in cellular gene expression (12). Specifically, although there is concern surrounding the use of prolonged HRT and increased risk of certain malignancies (i.e. adenocarcinoma of the breast), the literature remains unpersuasive. After surgery, you will likely experience some discomfort and soreness for several days to a week. Male breast enhancement may be able to help you achieve the result you desire. Do you wish you had larger chest muscles? Some men have more complex chest concerns that go beyond nipple size alone. Wondering if you’re a good fit for nipple reduction men surgery? The reasons men come to us for nipple reduction men procedures are both practical and deeply personal. This addresses that “puffy” appearance where the areola seems too large or the tissue underneath is enlarged. Areola reduction targets the pigmented skin around the nipple. With the combined clinical and histopathological appearance, we diagnose bilateral hamartomatous lesion of the nipple, probably induced by anabolic drugs. (A) Bilateral and quite symmetrical enlargement of both nipples. We present a bilateral enlargement of both nipples, histopathologically mimicking a smooth muscle hamartoma, but containing additionally lactiferous ducts. Excessive use of marijuana or alcohol will also affect hormone balance, as well as some Illegal substances, such as heroin.The procedure consists of en-bloc removal of both NAC, resizing of the areolas and re-grafting on the chest.The day before surgery, follow all pre-operative instructions carefully.Dr. Vij can rectify these conditions by conducting nipple surgery for males with ease.It also makes small amounts of the hormone estrogen.A meta-analysis published in the European Journal of Surgical Oncology in 2018 summarized 18 articles which described a total of 22 breast cancer events (median age of 51.5 at diagnosis) in MTF patients.Especially the notion of using fixed distances in transgender men seems to fail to consider that the generally shorter and narrower chest seen in transgender men, does usually not allow for the fixed measurements founds in cisgender men. Bootstrapping was used to assess the performance of the model, as this is the most efficient internal validation procedure (Steyerberg, 2019). The nipple position of these participants were placed according to standard practice of approximation and eyeballing. To test the accuracy of current practice, we collected anatomic measurements in a secondary cohort of trans men, who had undergone an inframammary mastectomy with free nipple grafts as part of a prospective clinical study (NTR7412). The central point on the nipple was considered to parameter for NAC position. It may sound wild to have a doctor coming at your nipple with a needle, but more women seem to be embracing the trend. Kim Kardashian's underwear brand – SKIMS – is even selling bras with built-in nipples to create that aesthetic of nipples poking through your shirt. One day, you are buying bras and pasties that hide your nipples, and the next thing you know, you are buying bras and pasties that accentuate them. Yet, what if you weren't born with perky, erect nipples and still want to get in on the trend? If you love the size of your breasts but are uncomfortable about the size of your nipples, nipple enlargement may be the answer.As in all of our coverage of breast enhancement, it is vital that readers understand that enhancement does not necessarily mean enlargement.Interestingly, the use of estrogen without progestin did not significantly increase the risk of breast cancer, even in survivors and patients at a higher baseline risk for breast cancer (15).I wanted to share my experience and offer women honest reviews of products I have used so you know what to expect and what may work for you as well.When considering plastic surgery to address any of the above concerns, always choose a board-certified plastic surgeon who is knowledgeable about and experienced in the many options available.At this point, the areola graft was positioned in the recipient area (Fig. 7), making a central hole with fine scissors allowing for the recipient skin to be placed precisely in the center of the graft (Fig. 8), as a neo-nipple.Scientific research on nipple reduction shows excellent outcomes for men seeking this procedure.Smooth muscle hamartoma are usually solitary and congenital, may affect the genital area and nipples.This has led to the standard practice of eyeballing the approximate location of the NAC during mastectomies, resulting in the NAC’s often being placed too high or too wide on the chest (Beckenstein et al., 1996; Berry et al., 2012; Hage & van Kesteren, 1995). Effects of Hormones and Hormone Therapy on Breast Tissue in Transgender Patients: A Concise Review Flutamide, an antiandrogen used as monotherapy in patients with prostate cancer, leads to gynecomastia development in 30 to 76% of treated men (52). These can also be used as an anti-androgenic agent in conjunction with estrogen therapy in adult MTF patients (18). Prolactin is stored and secreted by lactotropic cells in the anterior pituitary, as well as in the decidua, myometrium, lymphocytes (41) in breast glandular and adipose tissue, peripheral adipose tissue (42), hair follicles, skin (43), and the prostate (44). After puberty, IGF-1 and GH levels gradually diminish, which has been a postulated cause for less dramatic breast development in MTF patients who initiate HRT-GD many years after puberty. Deficiencies in either of these hormones or defects in their receptors have been correlated with diminished or absent breast growth in natal females. This appearance is often seen in patients with enlarged breasts or may develop with time as the skin ages and the nipples appear to hang lower or point downward. People undergoing gender re-assignment surgery, transsexuals and cross-dressing males may want to increase their breast size for a more feminine appearance and to fit in women’s clothing better. Plastic surgery offers the best male breast reduction treatment option, as it effectively removes the tissues and fat that are responsible for creating the breasts. The most effective solution is male breast reduction surgery, involving tissue and fat removal, and sometimes repositioning the nipple for natural results. Not only is the Noogleberry very effective it is very inexpensive, but the complete Noogleberry kit with medium cups also cost under $75.00, making it a very affordable alternative to other breast enhancement methods. The bottom line is that the Noogleberry does work, I have always been amazed at how well it has worked for women, and, even more amazed at how well it works for men. You may also feel irritation and temporary discomfort following the procedure. Of note is the use of antiandrogen agents in the MTF population to reduce the effects of endogenous testosterone. Transgender patients are often prescribed hormone antagonists in conjunction with HRT, creating a hormonal milieu that has yet to be adequately described in the literature. Despite the use of hormone replacement therapy (HRT) for over a century, there is still no consensus on HRT dosing and monitoring for transgender patients (2). Evidence-based treatment of gender dysphoria aims to affirm the individual’s gender identity through a combination of counseling, exogenous hormones, and sometimes gender-affirming surgery (1). In order to enable accurate prediction of NAC position, two accompanying models were developed to predict nipple-to-nipple distance (NN) and sternal-notch-to-nipple distance (SNN). All had undergone a double incision mastectomy at the inframammary level with free nipple grafting. Most algorithms performed worse in predicting the nipple position compared to using the mean of NN and SSN values. Within these patients with the mean and outlier variables, the range of error for NN was −1.7 to 1.1 and −0.7 to 0.7 for SNN. Medication-Induced Gynecomastia The graft was taken from the pigmented skin from the areola leaving a central 5 mm diameter of thoracic/ recipient skin.Prolactin itself does not directly stimulate breast development but rather increases ER and PR expression, as well as the endogenous synthesis of both hormones.In women who have tuberous breasts, a condition in which the breast tissue is constricted, the areolas appear significantly enlarged and somewhat distorted relative to the amount of breast tissue and breast skin.Estrogen shots will allow the estrogen to become the dominant hormone and lower your testosterone levels.Nipple areolar complex (NAC) positioning in men has been studied to a far less extent than in women (Lewin et al., 2016).Prolactin is stored and secreted by lactotropic cells in the anterior pituitary, as well as in the decidua, myometrium, lymphocytes (41) in breast glandular and adipose tissue, peripheral adipose tissue (42), hair follicles, skin (43), and the prostate (44).Specifically, although there is concern surrounding the use of prolonged HRT and increased risk of certain malignancies (i.e. adenocarcinoma of the breast), the literature remains unpersuasive.This video below explains my nipple method.About nipple filler specifically, she also cautioned women to consider waiting on the procedure until after having children. The incisions are quite small – usually less than a centimeter – and I place them strategically within the natural contours of your nipple. Let me put your mind at ease – the scars from this procedure are typically very minimal and well-hidden. Most of my patients are amazed by how quickly they can return to their full workout routine. By week four, you’re typically cleared for everything – including chest exercises like push-ups and bench press. In total, 4 predictors were selected using best subset regression age, weight, chest circumference (CC), anterior axillary fold to anterior axillary fold (AUX-AUX) (Table 4).Nipple reduction focuses on the projection itself – that central part that extends outward from your chest.Unlike most other body parts, exercising or dieting will not make any difference to protruding nipples.Nipple enhancement with dermal fillers can improve the prominence of your nipples for an eye-catching, feminine aesthetic appearance.Nipple surgery can be performed on its own but often is combined with some type of Breast Surgery.Nipple enlargement surgery is an outpatient procedure done at your plastic surgeon’s office.A 40-year-old male presented with progressive bilateral enlargement of both nipples excised due to cosmetic concerns.Hormones are very effective at growing natural breasts and might also be less effective for reducing natural breasts. Therapeutic regimens are often provider-dependent and there are no uniform guidelines in place for cancer surveillance in transgender patients. Depending on the type of Nipple surgery you will be having, Mr Rezai will discuss the possible risks and complications with you at consultation. It is important to follow Mr Rezai’s pre and post surgery instructions. Wearing a good support bra for the weeks following the surgery is also recommended. During the procedure, you may also seek to enlarge or reduce your areolas to better match the size and shape of your breasts. The procedure improves nipple protrusion, while giving you more erect nipples that beautifully crown your breasts. If you love the size of your breasts but are uncomfortable about the size of your nipples, nipple enlargement may be the answer. Traditional nipple grafts harvested from the areola are often flat or depressed. All patients healed uneventfully and none of them required revision surgery or correction. The graft was taken from the pigmented skin from the areola leaving a central 5 mm diameter of thoracic/ recipient skin. The aim of the present paper was to develop and apply a simple new method of nipple-areola complex free graft. Chest-Wall Contouring is generally the first surgical step Trans Men sex reassignment surgery. Most men who feel self-conscious about their nipple size or projection make excellent candidates. Nipple reduction focuses on the projection itself – that central part that extends outward from your chest. The difference between nipple and areola is important to understand. Skin biopsy shows a slightly hyperplastic epidermis and haphazardly arranged fascicles of smooth muscle within the reticular dermis (Figure 2A). (B) Elastic consistency of a nipple with a length of 11 mm. No medical relevant history, but intake of anabolic steroids to improve his physical performance. Nipple lift is part of both breast lift and breast reduction surgery, which are procedures that correct hanging breasts and enlarged breasts, respectively.The breasts often grow unevenly and may appear as a lump or fatty tissue beneath the nipple.In some men, the testosterone is unable to inhibit the estrogen, which is why male breasts are formed.The recovery timeline for nipple reduction men is actually quite reasonable compared to other procedures.Most women have insecurities about their bodies and appearance, and surgery to enhance the female breast is pretty common.Diagnosing gynecomastia involves a comprehensive evaluation of the patient’s medical history, a physical examination, and various tests.Dr. Landis will determine the best approach to your unique surgery during your consultation. There are ways men can make their breasts bigger and avoid all the red tape and medical evaluations required by doctors. Unfortunately, breast surgery for men is more complicated than it is for women.trailertrash A lot of men believe that the only way that they can make their breasts bigger is with surgery. In this article, I will tell you about 4 ways men can make their breasts bigger without surgery. Depending on the goals with areola reduction surgery, your treatment options will be discussed with you during consultation. Many times, for individuals with mild nipple inversion, a temporary nipple piercing, or breast augmentation may improve the projection of the nipples. If you’ve had inverted nipples all your life, it is usually harmless, though they can sometimes make breastfeeding more difficult. In extreme cases inverted nipples can affect a woman’s ability to breastfeed. The hormones testosterone and estrogen control sex traits. Like estrogen HRT-GD in MTF patients, exogenous testosterone leads to negative feedback on hypothalamic-pituitary axis resulting in a decrease in estrogen and prolactin production. With or without mastectomy, most studies suggest that testosterone therapy leads to a reduction in breast cancer risk (23). Therapeutic doses of testosterone lead to a decrease in breast glandular tissue and overall adipose tissue, as well as an increase in breast fibrous connective tissue (22,23). In post-oophorectomy FTM patients receiving exogenous testosterone (with dosing adjusted to achieve normal male serum testosterone concentrations), estradiol levels are comparable to those in natal men. Dark colors and patterns can help minimize nipple visibility, and well-fitted undershirts provide some camouflage. Before considering surgery, some men try working around their concerns with compression shirts or strategic clothing choices. Most men retain normal nipple sensation, and the minimal scarring fades significantly over time. Results are permanent – once we remove the excess tissue, it won’t grow back. To address breast, gonadal and prostate health risks, which may be altered by HRT-GD, consensus guidelines are needed so that surgeons and physicians can properly educate patients and close the health disparity gap affecting so many transgender individuals. MTF individuals experience variable degrees of breast development due to HRT-GD while FTM patients typically have residual breast tissue for both inadvertent (technical) and intentional (aesthetic) reasons after complete mastectomy. Conversations between providers and transgender patients about the long-term risk of breast cancer are often incomplete due to the lack of robust scientific data to address this question. As discussed above, progesterone activity on breast tissue includes lobuloalveolar maturation in conjunction with prolactin and, to a much lesser degree than estrogen, ductal development. Certain health conditions that affect the balance of hormones can either cause or be linked with gynecomastia. Estrogen levels that are too high or are out of balance with testosterone levels can cause gynecomastia. Estrogen controls traits that include the growth of breasts. It also makes small amounts of the hormone estrogen. It is also essential to recognize that a person’s breast size does not define their worth or value as a person. Once the procedure is complete, the medical expert will close the incisions with absorbable stitches and cover them with antibiotic ointment and bandage. Nipple reduction surgery in India might cost anywhere between ₹ 25,000 – ₹ 1,00,000 on average.