NEW DELHI: Cosmetic surgeons in Delhi are baffled by the sudden increase in demand for breast reduction by young men. Doctors say they get eight to 10 such cases monthly while the number of women seeking breast reduction is no more than three a month.Doctors say besides hormonal problems, steroid use among gym-goers, obesity and other lifestyle factors are reasons behind this phenomenon.“Incidence of breast enlargement has increased enormously in young men. Till about a decade ago, we rarely had male patients coming for reduction of the breast. These days, we get two to three such cases every week,” Dr (Major General) A S Bath, head of plastic and cosmetic surgery department at BLK Super-Specialty Hospital, says.Called gynaecomastia in medical terms, breast enlargement in men is caused by imbalance in male and female hormones—androgens and oestrogen. It’s more frequent in boys aged between 19 and 25 years, though a few cases are also observed in middle-aged people. It’s a common misconception that men do not have female hormones. “They are present, but in smaller amounts. Hormonal imbalance occurs naturally when a patient’s body is more receptive to female hormones, but such cases are rare. In most cases, it is caused by external factors—poor nutrition, steroid use and physical inactivity,” Dr Bath says.Experts point out that most dairy and meat animals are injected with growth hormones for quicker and better produce and their ingestion, too, causes hormonal imbalance. Lack of physical inactivity only adds to the effect. Indeed, according to Dr Sunil Choudhary, director of aesthetic and reconstructive plastic surgery at Max Healthcare, lifestyle has played a big role in the new epidemic.“Those aspiring to be super-fit or trying to ape superstar six packs take the short cut by using nutritional supplements laced with steroids. These inhibit production of androgens. Under influence of increased relative activity of oestrogens, male breast enlargement occurs,” Dr Choudhary says. He strongly condemns steroid use for body-building. “Steroid supplements are banned in professional sports. They can cause kidney failure.”It has been found that in obese people, there is increased activity of the enzyme, aromatase, which causes conversion of androgens into oestrogens. “Being female hormones, oestrogens cause breast enlargement in obese men. It’s important to stop use of steroid,” says a senior doctor.Kamlesh Verma (name changed) says his son had enlarged breasts due to which he never participated in sports. “I took him to a plastic surgeon myself. The treatment involved dissolving the extra muscle and sucking the fat inwards,” he says. Verma says more people are now seeking such treatment.