Really could use some Feedback.

[Mts209]

I hope this is the right thread for this posting.

First off I am not a young man, but 64 years old.  I have been aware of my puffy and now large breasts since just about puberty.  In fact I remember using band aids over my nipples at night hoping they would get flatter and tighter.  The silly things we did in our youth.  I am in pretty good health and walk 3 to 4 miles every day and have lost 28 pounds over the last 9 months.  I still have 10 or 15 pounds to go.

As I mentioned I have always been aware and very self conscience of my breast.  However, I do believe it was been within this past year I have really noticed the sagging and larger looking breast.  I assume perhaps from the weight loss.  Therefor I wonder if it is actually attributed to the weight or in fact  gynecomastia.

I will attach some current pictures.  I have not talked to any doctors yet.....in fact until I found this Forum (bless you). I really did not know it was a condition and even had a name!  So, where does one start....after posting here, that is.  Do I first go to my GP (I have Kaiser Ins. & don't know if they will cover a thing).   If so, what to I tell my doctor?  What kind of questions do I ask him?  Are there other treatments besides surgery?  At my age I do take certain medications, are there any that can cause or exasperate the condition?  I realize an exam is needed to fully diagnose my condition.  However, what are your thoughts and perhaps suggestions after viewing my photos.  

Thank you, mts

[Litlriki]

Based on your photos and your story, you have gynecomastia.  This entity is common at 3 points in life--newborns may have swelling of their breast bud from stimulation due to maternal estrogens circulating across the placenta, adolescents have all sorts of fluctuation of hormones in going from "boys to men," and in older age, as testosterone levels drop and depending on estrogen levels and body fat, older men may evidence gynecomastia--which looks like your photos.  If your condition has worsened as a result of increased levels of body fat, then diet and exercise may help to remedy the situation at least to the point prior to a year ago, when you state it got worse.  On the other hand, if it's worsened as a result of low testosterone levels, you might benefit from hormone replacement--not just your chest, by the way, but other factors influenced by aging.  Of course, there are pros and cons of male hormone replacement therapy, and you should explore this completely before embarking on that option. 

You can certainly start by consulting with your primary care doctor.  He can rule out any medical factors that are particularly problematic, such as tumors or other conditions that have caused gynecomastia to develop as a sign of the condition.  Once that has been addressed, you can consult with a plastic surgeon to address the appearance.  This is generally considered cosmetic, so it probably will not be covered by insurance. With that in mind, take the time to find a surgeon who specializes in care of gynecomastia, as your situation is not a simple one, at least in my experience.  Older patients often require a different approach to dealing with this condition than younger patients, particularly in the face of weight fluctuation over the course of one's life, as well as loss of skin elasticity. 

Good luck,

Rick Silverman

[Mts209]

Thank you Dr. Silverman.....you have given me a bit more info to go on.

[DrPensler]

I would note that you have gynecomastia. Gynecomastia correction is rarely covered by insurance.
You have a high bmi ( body mass index ) ,essentially part of the problem is excess weight.Excess weight is not the only component of the problem and weight loss which will offer some improvement will not correct the problem.A component of your problem is excess tissue in the breast both glandular and fat.Because of your age skin laxity will also play an important role in your final result.You should see an individual with experience with gynecomastia to optimize your result if you decide to have surgical correction.

[Mts209]

Thank you also for taking the time to give me some feed back.