Questions/concerns regarding surgery

[Gustav270]

Hi,

Like everyone else on these forums, I have a few questions/concerns about gynecomastia and possible ways to treat it.

History:  I've had gynecomastia for almost as long as I can remember (or at least it seems that way).  I would guess somewhere in the 10 years old range (I'm 23, almost 24 now).  My dad has pretty large breasts (he was a body builder when he was younger) and my older brother has developed breasts as he's gotten older and my younger brother has the puffy nipples version (he's really skinny, 6'4" 160 lbs).  I am 6' 3", 190 lbs.  I did lose a lot of weight (I weighed 170 lbs), and didn't notice any difference, since then, I've worked out and gained some weight back.

Situation:  I have scheduled an appointment with a physician, the soonest he could see me is November 13th.  I have never seen this physician because I just moved to a new area.  I live in Albert Lea, MN and most of the hospitals/clinics in the area are in the Mayo Health System.

Questions/Concerns:

              1. Does surgery sound necessary or would other methods of treatment be more desirable for my situation?
              2. Could anyone recommend a good surgeon to perform the surgery?

I would like to have surgery and be done with it personally.  I am considering a flexible spending account to pay for it, however, the deadline for it is November 16th, and if I don't use the money I lose it.  The earliest I can see a physician is the 13th (not to mention an endocrinologist, surgeon, etc), so I doubt I'll have enough time to make a decision on the spending account based on my appointment.  So any advice/comments would be greatly appreciated!

-Kyle

[Dr. Elliot Jacobs]

Your history does sound like gyne -- but posting appropriate photos would be helpful.

There are some excellent surgeons in the Mayo health system.  However, the timing for using your HSA doesn't sound like it could work.

I do see patients from across the US (and the world) and would be pleased to provide you with a free evaluation via email.  If you are interested, please send me a PM with your email address and refer to your post so that I will know the appropriate reference.  It is possible that we might be able to meet your deadline -- but you would have to come to NYC.

Dr Jacobs

[DrBermant]

Hi,

Like everyone else on these forums, I have a few questions/concerns about gynecomastia and possible ways to treat it.

History:  I've had gynecomastia for almost as long as I can remember (or at least it seems that way).  I would guess somewhere in the 10 years old range (I'm 23, almost 24 now).  My dad has pretty large breasts (he was a body builder when he was younger) and my older brother has developed breasts as he's gotten older and my younger brother has the puffy nipples version (he's really skinny, 6'4" 160 lbs).  I am 6' 3", 190 lbs.  I did lose a lot of weight (I weighed 170 lbs), and didn't notice any difference, since then, I've worked out and gained some weight back.

Situation:  I have scheduled an appointment with a physician, the soonest he could see me is November 13th.  I have never seen this physician because I just moved to a new area.  I live in Albert Lea, MN and most of the hospitals/clinics in the area are in the Mayo Health System.

Questions/Concerns:

              1. Does surgery sound necessary or would other methods of treatment be more desirable for my situation?
              2. Could anyone recommend a good surgeon to perform the surgery?

I would like to have surgery and be done with it personally.  I am considering a flexible spending account to pay for it, however, the deadline for it is November 16th, and if I don't use the money I lose it.  The earliest I can see a physician is the 13th (not to mention an endocrinologist, surgeon, etc), so I doubt I'll have enough time to make a decision on the spending account based on my appointment.  So any advice/comments would be greatly appreciated!

-Kyle

Weight Loss Can Help with the Fat component of Gynecomastia, but not the gland. I work with many Bodybuilders with Gynecomastia and many complain as they build muscle, what was on top just got pushed further out. Options for treatment depend on many factors best explored during a consultation where more details can be learned before advice is given.  Our Preliminary Remote Discussion helps the many patients we see from around the world minimize travel to Virginia.

Your timing with the Flex Spending Account is a problem. With such short notice, you need to find a surgeon who is just not that busy that there is time on the schedule. However, why does that surgeon have that time?  Better surgeons are booked well in advance for surgery, but openings do happen.  You do need to carefully evaluate that particular surgeon's skills.  You may regret rushing into a decision!

I have posted on How to Pick a Gynecomastia Surgeon here in this forum:

http://www.gynecomastia.org/smf/index.php?topic=16474.0

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Gustav270]

I don't plan on having the surgery that quickly.  The spending account is for 2010, so I can get the surgery anytime next year.  My main concern is whether or not surgery is an appropriate solution for my problem so that the money I'm going to be putting in to the account doesn't go to waste (since you lose it if you don't use it). 

I plan on taking my time and finding a good surgeon for the procedure, but the decision to put money in to an account has to be made by November 16th.  I more or less wanted to ask an expert if what I have sounds like a typical case of gynecomastia based on me and my family's history. 

I will throw up some pictures, although I only have a camera phone so hopefully they will be clear enough

[DrBermant]

I don't plan on having the surgery that quickly.  The spending account is for 2010, so I can get the surgery anytime next year.  My main concern is whether or not surgery is an appropriate solution for my problem so that the money I'm going to be putting in to the account doesn't go to waste (since you lose it if you don't use it). 

I plan on taking my time and finding a good surgeon for the procedure, but the decision to put money in to an account has to be made by November 16th.  I more or less wanted to ask an expert if what I have sounds like a typical case of gynecomastia based on me and my family's history. 

I will throw up some pictures, although I only have a camera phone so hopefully they will be clear enough

Not rushing is usually the best.

For my remote discussions we use:

Standard Pictures to Evaluate Gynecomastia

or, if after weight loss sagging is a factor:

Standard Pictures to Evaluate Loose Skin and Gynecomastia

In addition we use a series of questionnaires to best advise a patient their best course of action and advice based on essential details. Specific advice beyond that in a forum is setting up a doctor patient relationship that the doctor can be held responsible for.  That is why my answers here are general and not specific.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Gustav270]

Well I wasn't able to take all of the standard photos, but hopefully this will do a decent job illustrating my situation.

[Dr. Elliot Jacobs]

Thanks for the photos.  Based on the photos and information you have provided (you are young, slender), I think you would be an excellent candidate for surgery.  Obviously, an appropriate medical history is necessary to make any formal recommendations.

As long as you have time, I would suggest you research plastic surgeons in your area and pick and choose very carefully. 

Best of luck!

Dr Jacobs