Treatment of gynecomastia by plastic surgeon Dmitry Valeryevich Shagan in Dnipro.

Patients present with an increase in breast volume in men, discomfort in the chest area, changes in the appearance of the breasts, or with recurring complaints following unsuccessful attempts at self-treatment.

The physician conducts a detailed clinical evaluation, carefully examines the symptoms, and takes a medical history, ordering additional tests if necessary to determine the cause.

The patient receives a clear, step-by-step action plan that includes recommendations for next steps, necessary examinations, and methods for monitoring the condition over time.

Special attention is given to differential diagnosis of the causes and to explaining the plan in simple terms, which helps patients better understand the process and confidently make decisions.

When to See a Doctor

If you notice changes in the breast area accompanied by discomfort or interfering with daily life, consulting a plastic surgeon can help determine the cause and identify the necessary steps. You should make an appointment with a plastic surgeon if, during gynecomastia treatment, you observe:

• Persistent enlargement of the male breast
• A feeling of heaviness or pain in the chest area
• Unusual changes in shape or breast asymmetry
• Periodic swelling in the breast area
• Increased discomfort when touched or under strain
• Symptoms that recur or gradually worsen
• Difficulty sleeping due to unpleasant sensations in the breast area
• No relief from self-care measures
• New complaints causing concern
• A need for a second opinion on previous examination results
• Symptoms worsening after lifestyle changes or therapy
• Noticeable discomfort affecting everyday activities

If you experience one or more of these symptoms, a consultation will provide a comprehensive understanding of your condition and help determine the next steps. An accurate assessment can prevent unnecessary worry and create a clear, personalized plan of action.

Urgent Conditions or When to See a Doctor Immediately

• Sudden rapid breast enlargement with sharp pain
• Increasing tenderness and swelling that restrict movement
• Combination of breast pain with pronounced weakness or dizziness
• Appearance of skin redness and elevated temperature over the breast area
• Sudden worsening of general condition accompanied by unexplained discomfort

If you experience any of these symptoms, do not wait for a regular appointment—seek emergency medical help. Our clinic offers a home visit service for prompt assessment of your condition.

Causes and Risk Factors in the Treatment of Gynecomastia

Understanding the possible causes and risk factors will help better comprehend why gynecomastia occurs and what should be checked when consulting a doctor. This will allow for a more effective evaluation and selection of therapy.

Main Causes / Mechanisms (briefly)

• Hormonal imbalance between male and female sex hormones
• Age-related changes affecting testosterone levels
• Effects of certain medications or substances
• Metabolic disorders and chronic illnesses
• Consequences of trauma or surgeries in the chest area

Risk Factors

• Advanced age, especially in men over 40 years old
• Overweight and obesity, contributing to hormonal changes
• Regular consumption of alcohol or certain medications
• Endocrine disorders, such as thyroid diseases
• Hereditary predisposition and family history
• Liver or kidney diseases affecting hormone metabolism
• Smoking, impacting the vascular system and metabolism

Reversible Causes That Should Be Ruled Out

• Use of medications capable of causing breast enlargement
• Temporary hormonal changes, for example during stressful conditions
• Exposure to certain substances or supplements without medical supervision

Gynecomastia is a complex condition with diverse causes; therefore, accurate understanding requires consultation and examination by a specialist.

Diagnosis

When seeking medical attention for gynecomastia, it is important to understand how the doctor conducts the evaluation and what steps the diagnostic process includes. This helps alleviate anxiety and prepare for the clinic visit.

Diagnostic approach

• Collecting detailed information about complaints and medical history
• Visual examination and palpation of the breast area
• Assessment of accompanying symptoms and risk factors
• Ordering basic laboratory tests as indicated
• Conducting additional studies (e.g., breast ultrasound) if necessary
• Analyzing results and developing a plan for further action

Common tests as indicated

• Ultrasound examination of the breast tissue
• Blood tests for hormonal profile
• General tests to assess overall health status
• Additional tests as decided by the physician if needed

What to bring to the appointment

• Previous examination and test results
• List of current medications
• Symptom diary or description of changes in condition
• Questions for clarifying the treatment and diagnostic plan

The diagnosis of gynecomastia requires a comprehensive assessment and an individualized approach, which helps to select the optimal examination plan and subsequent follow-up.

Treatment

The treatment is aimed at reducing the manifestations of gynecomastia and improving the patient's overall condition. The therapy plan is selected individually, taking into account examination results and health characteristics.

Therapy Goals

• Reduce the severity of symptoms and discomfort
• Correct the underlying causes contributing to gynecomastia development
• Improve quality of life and physical comfort
• Prevent possible complications and progression of the condition

Main Treatment Approaches

• May include medicinal methods as indicated and prescribed by a doctor
• Use of non-medicinal approaches to support overall health
• Surgical intervention if necessary to correct breast shape
• Individual selection of therapeutic measures considering comorbidities
• Combination of methods with regular reassessment of the treatment plan

What the Doctor Does

• Selects and adjusts therapy depending on the condition’s dynamics
• Takes into account all comorbidities and patient-specific factors
• Monitors possible side effects and adjusts the regimen if needed
• Explains the criteria for evaluating treatment effectiveness
• Coordinates with other specialists for a comprehensive approach

What to Expect: Plan and Monitoring

• Approximate frequency of monitoring and outcome evaluation is determined individually
• The plan is adjusted if there is no improvement or new symptoms appear
• Follow-up visits are necessary for observation and therapy clarification
• Careful monitoring helps adapt treatment and maintain patient comfort

To arrange an individualized treatment plan, please schedule a consultation with Dr. Shagan Dmitry Valeryevich.

Prevention

Prevention is important for reducing the risk of developing gynecomastia and maintaining the health of the male breast. A preventive plan is tailored individually, taking into account the characteristics of the body and medical history.

Main primary prevention measures

• Weight control and maintaining a healthy lifestyle
• Limiting alcohol consumption and quitting smoking
• Careful adherence to prescribed medications as directed by a doctor
• Regular monitoring and management of chronic diseases
• Reducing stress factors and supporting overall emotional well-being

Screening and secondary prevention / regular monitoring

• Regular examinations by a specialist as indicated
• Monitoring hormonal balance according to your doctor's recommendations
• Assessment of breast condition if any changes or discomfort arise

Practical advice

• Discuss with your doctor the need to adjust medications for concurrent conditions
• Monitor any changes in breast condition and seek consultation promptly
• Maintain the recommended physical activity for overall health
• Avoid self-administering medications without consulting a specialist

Adhering to preventative measures helps reduce the risk of complications and maintains a comfortable condition of the breast in cases of gynecomastia.

Important to Know

Treatment of gynecomastia requires a careful approach to identifying the causes and triggering factors, not just addressing the external symptoms. Early assessment helps determine the optimal strategy and reduces the risk of complications or progression of the condition. Sometimes, dynamic monitoring and adjustments to the treatment plan are necessary depending on changes. Various factors can influence the course of the condition: physical activity, stress levels, sleep quality, and the presence of comorbidities. Self-treatment attempts can obscure the clinical picture, cause side effects, and delay accurate diagnosis.

• It is important to understand the causes of gynecomastia, not just relieve the symptoms
• Early consultation helps choose the right treatment and avoid complications
• Dynamic observation allows timely adjustments to the therapy strategy
• Lifestyle factors and comorbidities affect the course of the condition
• Self-medication can mask the problem and complicate diagnosis
• The doctor explains the treatment plan in clear language and supports the patient at every stage

For more detailed information on gynecomastia and its treatment, we recommend visiting the clinic’s main page, where all aspects of this issue are covered.

Self-care Before the Appointment: What You Can and Cannot Do

Before your appointment with Dr. Dmitry Valeryevich Shagan, it is important to take safe measures that will help maintain diagnostic accuracy and not worsen your condition. If your condition deteriorates at any time, it is recommended to seek medical help immediately.

What You Can Do Before the Appointment

• Write down when and how changes in the breast area started, and what makes the condition better or worse
• Bring a list of all medications you are taking, including dosages and frequency
• Monitor symptom changes, keep a diary noting the intensity and timing of symptoms
• Reduce physical activity, avoid heavy exercises to prevent increasing discomfort
• Ensure you get enough rest and avoid stressful situations as much as possible
• Drink plenty of water to maintain overall wellbeing
• Measure and record your temperature and pulse if you know how to do this safely
• Wear comfortable clothing that does not put pressure on the breasts

What You Should Not Do Before the Appointment

• Do not change or stop taking medications without consulting your doctor
• Do not start taking new medications or supplements on your own
• Do not use folk remedies or recipes without consulting a specialist
• Do not ignore increasing pain or other alarming symptoms
• Do not attempt to self-diagnose based on symptoms or information from the internet
• Do not delay seeing a doctor if your condition worsens or new symptoms appear
• Do not use strong painkillers or other remedies without your doctor’s recommendation
• Do not subject your breasts to excessive strain or injury

If you experience signs of worsening or emergency conditions, seek medical assistance from Dr. Dmitry Valeryevich Shagan immediately.

How I Can Help as a Doctor with Gynecomastia Treatment

During a consultation for gynecomastia treatment, I can assist you in the following ways: identifying possible causes of the changes, evaluating your condition, and selecting the most appropriate course of action to improve your well-being and health.

• Review symptoms and medical history to identify likely contributing factors
• Assess the severity of the changes and any associated risks
• Analyze current medications and their tolerability if treatment has already been initiated
• Develop a plan for further steps: diagnostic tests as indicated, treatment, and follow-up
• Take into account any comorbidities and drug interactions
• Provide lifestyle and regimen recommendations tailored to your individual needs
• Explain how to monitor progress and when to seek follow-up care
• Evaluate risk factors and coexisting conditions for a comprehensive approach
• Adjust therapy if there is inadequate response or if side effects occur

The consultation allows for a thorough understanding of the specifics of your condition and for determining suitable measures to achieve the best possible outcome. It is important to consider all aspects of your health to ensure an effective and safe gynecomastia treatment process.

Questions to Ask Your Doctor When Being Treated for Gynecomastia

• What causes the gradual or sudden enlargement of male breast tissue and what sensations might be associated with it?
• Is the breast area expected to be painful or uncomfortable?
• What do changes in breast shape, asymmetry, or other visible signs indicate?
• Why might symptoms persist or recur without resolving on their own?
• What should be done if previous treatments have not been effective?
• How might other health conditions or medications affect my gynecomastia?
• What diagnostic tests or examinations will I need, and how should I prepare for them?

If you experience sudden increased pain, significant redness, severe swelling, or other acute symptoms, seek emergency care rather than waiting for a scheduled appointment.

Additional Questions to Discuss with Your Doctor:

• What exactly is happening with my condition, and what might it be?
• Why has this condition possibly started now?
• How can we be sure these symptoms are due to gynecomastia and not another illness?
• Which investigations are specifically necessary in my case?
• Which tests are mandatory and which might be optional?
• How should I prepare for the examinations and consultations?
• What treatment options are available, and how do they differ?
• Is surgery avoidable in my situation?
• Why might the prescribed treatment not be working, and what are the next steps?
• How long does treatment typically last, and how often should I have follow-up evaluations?
• What signs indicate improvement or worsening of my condition?
• What actions should I take if my condition suddenly worsens or flares up?

Consulting a specialist allows for a comprehensive assessment, appropriate selection of diagnostic and therapeutic methods, and development of a plan for monitoring and preventing complications. It is important to consider your individual health circumstances and respond promptly to any changes.

How the Consultation Takes Place

A consultation with a plastic surgeon regarding breast issues involves a careful review of your complaints, an assessment of your condition, and the development of a plan for further action. The scope of necessary examinations is determined individually and depends on your symptoms and medical history. It is not always possible to obtain a complete diagnosis in one visit, so it is important to openly discuss all questions and follow the doctor's recommendations.

1. Clarifying complaints and visit goals: I find out exactly what concerns you, when the changes began, how they affect your life, and what you expect from the treatment.
2. Collecting medical history and risk factors: We discuss any concurrent illnesses, medications you are taking, and possible triggering causes.
3. Reviewing previous examinations and treatments: If you have test results or studies, bring them along with a list of current medications.
4. Breast examination and palpation: This is performed gently and painlessly to assess shape, size, and the presence of any unusual formations.
5. Preliminary evaluation: We discuss possible causes of your symptoms and rule out the most serious conditions, without making a diagnosis based solely on your description.
6. Examination plan: If indicated, I may recommend ultrasound of the mammary glands, blood hormone tests, and other investigations.
7. Developing a treatment and management plan: I select appropriate therapy and monitoring methods based on your condition and medical history.
8. Follow-up and support: We discuss timing for repeat visits, self-monitoring methods, and when you should seek unscheduled care.

If this is your first visit, the consultation will help to specify your symptoms in detail and identify possible causes. If previous treatment has not resulted in improvement, we will analyze why and adjust the further course of action together.

Preparation for the Appointment

To ensure that your consultation with the plastic surgeon is effective and helps to quickly develop a treatment plan, it is important to prepare properly for your appointment. This will speed up the diagnosis process and make your visit as beneficial as possible.

• Bring a list of all your current medications, including names and dosages if known
• Bring results of previous examinations, images, and tests: breast ultrasound, hormonal tests, general blood work
• Write down your main complaints: when and how symptoms begin, what helps or worsens them
• Prepare questions and topics you want to discuss with the doctor
• Arrive 10–15 minutes before your scheduled time for registration
• Do not stop taking prescribed medications without consulting your doctor
• Follow any fasting instructions if given (e.g., 8–12 hours without food or water, if recommended)
• Avoid using cosmetics on the breast area and strong fragrances before your visit
• Clarify any specific preparation requirements when making the appointment if you have doubts
• Wear comfortable clothing that does not put pressure on your breasts

If you have any questions about preparation, it’s best to check with the reception in advance. Do not change your medication regimen without your doctor’s approval to ensure safety and diagnostic accuracy.

About the Doctor

Dmitry Valeryevich Shagan is a plastic surgeon with 20 years of experience. In his practice, he often works with patients seeking treatment for gynecomastia, including initial consultations, cases with no effect from previous therapies, and cases involving comorbid conditions.

He focuses on thorough analysis of the causes and individual selection of treatment strategies, taking into account the patient's health specifics. The doctor explains each step and provides recommendations that are clear to the patient.

During the consultation, you will receive a clear assessment of the situation and a plan for further actions.

Why Patients Choose Dr. Dmitry Valeryevich Shagan

A comprehensive and precise approach is crucial in the treatment of gynecomastia. Dr. Dmitry Valeryevich places special emphasis on identifying the causes of changes and performing thorough differential diagnostics, which helps avoid unnecessary examinations and procedures. In his practice, he takes into account all comorbidities and medications, ensuring safety at every stage of treatment. The doctor carefully reviews previous prescriptions, adjusting therapy in cases of insufficient effect or side effects. Clear explanations of the treatment plan and evaluation criteria enable patients to better understand the process and feel confident. Continuous monitoring and adjustments allow for flexible responses to changes in the condition, considering individual characteristics.

• Clear action plan: what to do now, how to monitor, and when to return for follow-up
• Examinations based on indications: minimal necessary set for accurate diagnosis
• Consideration of comorbidities and medications for safe therapy
• Monitoring the progression and timely adjustment of treatment based on results
• Review of previous prescriptions and assistance with inadequate effects or complications
• Explanation of goals, risks, and alternatives in simple, understandable language
• Focus on prevention of exacerbations and possible complications
• Experience managing complex and recurrent cases of gynecomastia

Choosing a doctor means choosing a consistent and transparent approach to solving the problem. Dr. Dmitry Valeryevich’s work helps patients gain a clear understanding of their situation and provides comfortable support throughout all stages of gynecomastia treatment.

Case Studies

Initial Consultation with Suspected Gynecomastia

A middle-aged patient presented with complaints of breast enlargement and discomfort in the mammary region. It was important to exclude serious causes and determine whether the symptoms were related to hormonal changes or other factors. After taking the medical history and conducting a physical examination, a diagnostic plan was developed, including necessary laboratory tests and imaging studies. The results revealed a benign nature of the changes, and an individualized treatment strategy was prescribed. At follow-up, a decrease in symptoms and stabilization of the condition were noted, with ongoing monitoring and lifestyle recommendation adjustments.

Treatment Adjustment in the Absence of Effect

An elderly patient returned after a course of treatment that did not produce the desired improvement. The medical focus was on reviewing previous prescriptions and assessing therapy tolerability. Additional examinations were ordered to clarify the reasons for ineffectiveness. After analyzing the data, the management strategy was modified, taking into account comorbidities and concurrent medications. Over several weeks, the patient showed improvement in overall condition and reduction of symptoms. The patient remained under supervision for timely therapy adjustments.

Chronic Course with Comorbidities

A young man presented with prolonged breast enlargement accompanied by chronic discomfort against a background of endocrine disorders. A comprehensive assessment was essential to ensure safe treatment considering all factors. A detailed review of complaints was conducted, and a diagnostic plan was established taking into account comorbid conditions. The patient received recommendations for monitoring and supportive therapy, which helped reduce symptom severity and improve quality of life. Regular follow-up maintains therapy stability.

Exacerbation and Prevention Plan

A middle-aged female patient came in with an acute worsening of well-being, characterized by pain and noticeable breast enlargement over a short period. It was necessary to rapidly exclude serious complications and determine the treatment approach for the exacerbation. Physical examination and emergency diagnostic measures were performed, and the treatment plan was adjusted with the addition of preventive measures against relapses. At subsequent check-ups, a reduction in symptoms and improvement of overall condition were observed. The ongoing strategy includes regular visits for monitoring and prevention of recurrent exacerbations.

Scheduled Monitoring and Support after Treatment Course

A patient with successful completion of a treatment phase attended a scheduled appointment for evaluation of results and follow-up monitoring. The physician carefully reviewed the progression, discussed well-being and potential risks with the patient. Recommendations were adjusted as needed, and a schedule for future examinations was established. This approach helps to promptly detect deviations and maintain stable condition over the long term.

How long does a consultation last?

The average consultation lasts 30–60 minutes. Please confirm the exact duration when booking.

How should I prepare for the appointment?

It is recommended to write down your symptoms and questions, prepare a list of medications, and bring test results.

What should I bring to the appointment?

Bring laboratory tests, imaging results, medical records from other clinics, and a list of medications you are taking.

Do I need to come fasting or are there any restrictions?

Usually no, unless specified otherwise at the time of booking.

How many visits are usually required?

The number of visits depends on the complexity of the situation; generally, several appointments are needed for examination and monitoring.

When can I expect to see the first results?

Initial changes are assessed individually and depend on the chosen treatment strategy.

What should I do if my condition worsens before the appointment?

If you experience worsening symptoms such as severe pain, swelling, or redness, seek emergency care immediately.

Can treatment be combined with my current medications?

This is discussed during the consultation; do not stop or change your medications without consulting your doctor.

Is it possible to have an online consultation?

Yes, remote consultations are available. Please inquire about the conditions when booking.

Can I come with existing test results?

Yes, please bring all relevant and up-to-date results for analysis and discussion.

Do I need to come for follow-up appointments and how often?

The frequency depends on the condition’s progress and treatment plan and is determined individually.

Can I get a second opinion from this doctor?

Yes, the doctor is willing to review your case and provide a detailed opinion.

What should I do if symptoms return after improvement?

Contact your doctor for an additional consultation and possible treatment adjustment.

What tests are usually prescribed?

Tests are selected individually based on symptoms and medical history.

What does the treatment plan include?

The approach depends on the cause and condition and includes monitoring, therapy, and outcome control.

Can I stop treatment on my own?

It is not recommended to stop or change treatment without consulting your doctor.

How is the progress monitored?

The condition is evaluated through follow-up visits and symptom changes, with adjustments to the plan as needed.

Which symptoms require urgent medical attention?

Sudden severe pain, swelling, redness, and fever require immediate medical care.