ANY chance gyne can return after surgery?

[adb7]

I've booked surgery here in Australia for early next year. just wanted to know, if i get the surgery done (excision most likely as im not fat), is there ANY chance of the gyne returning? i dont smoke pot and i dont take steroids. i dont know if my hormone levels are good, is it something i should check out before surgery, just for piece of mind?

[DrBermant]

I've booked surgery here in Australia for early next year. just wanted to know, if i get the surgery done (excision most likely as im not fat), is there ANY chance of the gyne returning? i dont smoke pot and i dont take steroids. i dont know if my hormone levels are good, is it something i should check out before surgery, just for piece of mind?

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. 

If you are using something that can stimulate breast regrowth, shreds of gland remain behind with any surgical technique.  It is just not practical to remove all elements of gland.  The problem is that there are fine fingers of gland that dissect between fingers of fat and can extend quite far into the chest. Take a look at the Anatomy of Gynecomastia to see what I mean.  Even with a radical mastectomy (a disfiguring technique used for some male breast cancer problems), some gland can remain.  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.

Regrowth of gland from stimulation can occur where shreds of gland remain behind. This can be behind the areola, along the deeper edges or margins of a zone of excision. 

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 for patients I have sculpted.  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.

Here is another example of Gynecomastia Breast Regrowth on my site.  Caution this is a graphic picture of the massive gland regrowth removed on the operating table.

This patient is rather unusual. He was a misdiagnosed genetic female who has lived his entire life as a male.  His birth certificate says male as does his driver's license. Yes, a terrible mistake labeling him male made from birth and early on not recognizing his Congenital Adrenal Hyperplasia.  His body has been exposed to high levels of androgens and estrogen since within his mother's womb. This results in an a condition better called Intersex than the older phrase Hermaphroditism.

I prefer to target the gland first with my Dynamic Technique. This permits me to remove most of the gland and then sculpt the remaining tissue to minimize contour problems.

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.  With my techniques and my Red Flag Evaluation System before surgery, I have only a few patients over the many years I have been doing surgery that I know have regrown.  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 and stabilizing the problem(s) causing gynecomastia, when possible, is much better. We help patients explore such issues during consultations or preliminary remote discussions.

Hope this helps,

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

[Dr. Elliot Jacobs]

In a nutshell, if you have had stable gyne for a long time, are not on any drugs (legal or recreational) or anabolic steroids, then the odds of re-growth after surgery are minimal.  You should, however, thoroughly check out your endo values just to make sure all else is in order.

There are other, more rare causes of gyne, which a general medical checkup should be able to find.

Dr Jacobs

[DrBermant]

Unfortunately the "normal medical exam" can fail. I have seen many patients who were missed by other doctors.  Take your time to listen to the entire Living with Klinefelter's Syndrome Video. This patient went through decades of medical exams in the military and required job physicals where the doctors failed to find his problem (or for that matter examine his testicles which were typical tiny vestiges common for this problem.)  In the movie, he discusses the failure of the many doctors for many years to help with his problem. Oh he had gynecomastia too, but that was not an issue. Getting his testosterone up to a normal functioning level has many more advantages than just stabilizing breast growth.

Hope this helps,

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