Clomid after gyno surgery?

[Gyno2110]

Hey doctors,
I had surgery in March  (gland/lipo) and soon after made an appointment with an endocrinologist to figure out if it was caused by low T.  Come to find out and I already knew that my T was on the lower end (240) I also had higher estradiol.  So my ratio was probably contributed to the gyno.  I'm only 37 and feel like I have other issues that are related to low T in which I would benefit  from some sort of treatment.   So he's started me on clomid.  This doesn't suppress my natural system as you probably know but restarts it by tricking it by blocking estrogen which tells my body to stop creating testosterone.   My question is have any of you had patients that had the surgery then went onto a SERM in which in triggered the gyno to come back.  I know you're  not endocrinologist so Im just asking for your own experiences.  Thanks.

[Gyno2110]

All these doctors on here that have done thousands of these surgeries and Not one has ever had a patient come back after that found out they had low T that caused the gyno in the first place and then went on to take either TRT or a SERM that were concerned about Gyno possibly coming back or it did?  WOW!

[Dr. Schuster]

I appreciate your question and even your surprise at the few comments. I think it is because this site tends to attract experienced gynecomastia surgeons. If the gynecomastia surgery is done well, there should be very little true breast tissue remaining. Therefore there would be very little to "enlarge" even if hormonally triggered. I have not seen what you are describing. Occasionally I will have a patient who has some resistant scar tissue that develops, or even a small amount of breast tissue that was missed. But these situations do not continue to enlarge. they are fairly easy things to have a quick fix. 

[Gyno2110]

Thanks Dr. Schuster, it's  not your typical is "is this gyno" question.  I suspected that if done right it shouldn't come back regardless of hormonal balances.  So, thanks for confirming that for me.   Hopefully that's my case while I'm trying to find a recipe for balancing mine to a healthier ratio.  Thanks again.

[Litlriki]

I generally advise my patients to check on any hormonal imbalance issues prior to surgery, since these could result in recurrence in the small subareolar remnant that is left behind to support the nipple.  I have seen recurrences related to further steroid or pro-hormone use, but these are uncommon, since more sophisticated users also take preventative measures with anti-estrogen agents. If you're watched closely, you will hopefully avoid any of these problems.