Can it ever grow back?

[bladerunner]

Hi,

Obviously I am a noob.  I am currently taking a very low dose of finasteride, and I have developed gynecomastia.  This has been daignosed by my GP.  I have hard tissue under my nips.  I workout and am in good shape, so my large/slim pecks still look alright in my shirts though if you were to look close enough, you could see the perkiness (especially in my right side which is swollen and hurts).  

The problem is my hair is very important to me and I would like to stay on the finasteride.  My GP says if I have surgery to have the tissue removed it cannot grow back.  Is this true?  It would be very frusterating to have surgery just to have it grow back in a short period of time.  I would like to rid myself of this problem and continue to take the medication.  I am looking into a good PS to do the job.

Thank you.

[Hypo-is-here]

Re-growth isn't remotely rare!

There have been many people on these boards who have required revision due to re-growth.

However it only happens if there is an underlying causative condition such as an untreated or inadequately treated hormone imbalance, liver problem etc.

For the majority of people this is NOT an issue as gynecomastia is usually caused by a temporary hormonal imbalance during puberty.

HOWEVER there are a significant minority of people for whom this is a potential issue.  

Which is why it is vital for ALL men who have gynecomastia and are contemplating a surgical procedure see an endocrinologist (they specialize in gynecomastia- surgeons do NOT they specialize in gynecomastia removal!!!) PRIOR to surgery to eliminate or treat such conditions.

Men who are found to have underlying conditions can have successful surgical procedures and avoid re-growth with adequate treatment, but this can only happen if the given condition is diagnosed.

Which means NOT sticking your head in the sand and jumping into surgery without seeing the aforementioned specialist.

You CAN'T think that re-growth only happens to other people as it is that type of ignorance that leads to such problems.  Everyone with gynecomastia NEEDS to see an endocrinologist as it is the ONLY way of ascertaining which boat you are in and the ONLY way you can act accordingly/appropriately.

Nothing can be gained from not knowing the reality of your individual situation, eliminate doubt- treat problems if they do exist- KNOWELDGE IS POWER!

[bladerunner]

Thank you for the response.  

So you are saying if finasteride is the culprit there is no way to remove most of the glandular tissue and be free of gynecomastia while continuing treatment of fin?

If most of the gland is gone, will it regenerate itself to pre-surgery size or will it be a smaller problem?  

[Hypo-is-here]

The situation is not that cut and dry.

What I will tell you is many people have found to their cost that finasteride caused gynecomastia, that many such people are seen commonly on these boards and that a website is dedicated to campaigning against the use of finasteride in such products.

What would it do in your situation post op?

Not for me to say, but you suspect it has caused the gynecomastia once already and re-growth certainly can and does occur for many men if hormones remain imbalanced.

If you want to play Russian roulette with your psychological state by getting surgery and then going back on finasteride based products that caused your original problem in the hope that you will not have a recurrence then I for one have got my fingers crossed for you....

Vascular changes post surgery can alter the ability of recurrence so you might be lucky.

Although you could always consider alternative options that do not include this product?

[bladerunner]

Once again thank you for your response.

I have had hair transplant surgery and it is crucial that I keep the remainder of my hair.  Currently I am still on finasteride at a very low dose despite the fact the tissue under my right nipple is swollen and painful.  My left breast did this very same thing about three weeks ago but now is no longer painful even though there is a hard mass underneath.  

My hopes are to surgically remove the tissue and not have a re-occurance.  I guess my best route would be to talk to an endo and see just how out of whack my hormones are.  Discounting this problem, I do not have any other extreme side effects.  My GP said my hormones look okay, but who knows if he is looking at the right indicators.  

I guess my main question is if most of the gland is removed, is it possible for it to grow back to its original size?

[Hypo-is-here]

Once again thank you for your response.

I have had hair transplant surgery and it is crucial that I keep the remainder of my hair.  Currently I am still on finasteride at a very low dose despite the fact the tissue under my right nipple is swollen and painful.  My left breast did this very same thing about three weeks ago but now is no longer painful even though there is a hard mass underneath.  

My hopes are to surgically remove the tissue and not have a re-occurance.  I guess my best route would be to talk to an endo and see just how out of whack my hormones are.  Discounting this problem, I do not have any other extreme side effects.  My GP said my hormones look okay, but who knows if he is looking at the right indicators.  

I guess my main question is if most of the gland is removed, is it possible for it to grow back to its original size?

I can't fault your attitude even if I do have a very different outlook/set of priorities (I would be more accepting of being bald than having breasts).

Unfortunately I think it is 90% likely that your gp has not tested dihydrotestosterone, which is what finasteride lowers.  He almost certainly incorrectly tested for testosterone, but hey this is something that most endocrinologists get wrong never mind gps.

Have you considered other products that do not contain finasteride?  

I believe there are some on the market that are supposed to be successful (Rogaine?).  It isn't something I know a lot about but I think it worth looking into generally, but then again you come across as someone who would have looked into such options.

Best of luck in any event.

[DrBermant]

Hi,

Obviously I am a noob.  I am currently taking a very low dose of finasteride, and I have developed gynecomastia.  This has been daignosed by my GP.  I have hard tissue under my nips.  I workout and am in good shape, so my large/slim pecks still look alright in my shirts though if you were to look close enough, you could see the perkiness (especially in my right side which is swollen and hurts).  

The problem is my hair is very important to me and I would like to stay on the finasteride.  My GP says if I have surgery to have the tissue removed it cannot grow back.  Is this true?  It would be very frusterating to have surgery just to have it grow back in a short period of time.  I would like to rid myself of this problem and continue to take the medication.  I am looking into a good PS to do the job.

Thank you.

Gynecomastia Surgery Does Not Prevent Regrowth


I caution each of my patients that surgery does not typically stop male breast growth.  If there is a problem with growing breasts, recurrence can happen.  Any of these medical problems and or these medications can cause gynecomastia. So, if you want to get worried about regrowth, you could get yourself evaluated for each of these conditions to see if they could be a factor.

Surgery also does not prevent weight gain in the chest.  Men tend to put weight on the belly and chest regions.  I educate each of my patients that this surgery will not prevent further breast growth.  It is like changing/fixing a tire with a nail.  Fixing/changing the tire will not prevent you from getting a new nail in that tire.

I take care of many patients with gynecomastia, as many as 8 in one day alone.  With all the gynecomastia surgery I have done, it is very rare to have regrowth.  One patient (who had surgery on only side by another doctor) came to me with pro hormone induced gynecomastia that only came back on the side that had no surgery.  His growth was massive on the one side and none on the other.  His surgery by that other doctor had left a massive crater - the skin was adherent against the chest wall with normal fat surrounding the ugly deformity.  One side looked like the deformity seen here.  The other side was almost a B cup breast so tender that I could barely examine it.  As with each patient who presented to me with current breast growth, he was referred for an endocrinology evaluation and stabilization before considering surgery.  I do not know if such radical surgery was a factor or not.   Even if it did, removing all fat under the skin just gives an unnatural look.

I prefer to target the gland first with my Dynamic Technique. This permits me to remove most of the gland and then sculpt the remainng tissue to minimze contour problems.  Any surgery technique, even radical breast mastectomy for male breast cancer can leave gland behind.  The problem is that there are fine fingers of gland that dissect between fingers of fat and can extend quite far into the chest.

You can see what I mean by fingers of gland here.

By concentrating on the gland first I am able to minimize the chance of breast regrowth.  It is very rare for my patients to have recurrence.  However, gynecomastia surgery does not stop breast regrowth.  For patients having breast growth, I have advised for many years that they should get their problem under control before surgery.  There are exceptions, such as young men with massive breasts that have not stopped growing.  That is why each case needs to be individually evaluated.  

Prevention of gynecomastia, when possible, is much better.

Secondary Surgery is often an option for those who had prior surgery.  Such issues are better discussed during a consultation with your surgeon or someone who can advise you about your options.  We help patients explore such issues during consultations or preliminary remote discussions.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[Hypo-is-here]

Dr Bermant is one of the best surgeons when it comes to gynecomastia as far as this website is concerned/knows.

Certainly he is without doubt ONE of the top surgeons in this field.

That said the last post was blatant advertising, he is very good at that as well!!!

I don't mind that as long as the overall point is honest, but I have to say when he says he has little instances of re-growth…Well I doubt this or at least question what he terms as little re-growth.

Unless we are talking about complete removal of breast tissue then there is bound to be a certain amount of glandular gynecomastia re-development in those that have hormonal issues.

Ultimately I think his claims are totally unreasonable, irrespective of his ability.

Unless he can prove a statistically better rate of success wiith a given set of people or in fact anyone- then these statements are idle...

[Paa_Paw]

Well said Hypo, Ditto on all counts.