Hi everyone,
I am new to the site. I recently (january) went on a cycle of prohormones which I was told were "safe" bc they do not cause testosterone to aromatize to estrogen. But, sadly, I started to feel a sensation in my nipples about two months ago and have been miserable since. The gland behind my nipple is growing out of control and it is affecting every aspect of my life. I had some blood tests and my estrogen levels are surprisingly normal, and my testosterone is actually a little high (in the 900 range, normal is 200-800 ish). I am looking into gynecomastia surgery in the future when this stops....it has been going for two months and the doctors just told me to wait it out!!
I have glandular growth behind my nipples about the size of ping pong balls, and I realize that this can be excised. As for the surround pectoral muscle/side of chest area - I have noticed a layer of tissue. I don't believe this to be fat, but some type of breast tissue. Not quite like the glandular tissue, but more likely a fibrous breast tissue. It is growing on my chest and to the sides of the chest all the way up to my armpit.
Can this "fibrous" tissue be removed via liposuction of some sort or will I be stuck with this forever? I have searched online for every gynecomastia information site and I am still not quite sure. Liposuction is normally used for adipose/fatty tissue, but I don't think this new layer is fat. Please help me out!!
Prohormones are unregulated powerful substances that just too many people are finding out the dangers of using. Just why the FDA is not regulating them, is beyond my understanding. Herbs, plants, and other "natural" items have been used as medications for years. The Digitalis plant has been used for centuries, it is just not refined and has unregulated strength of the drug.
I have seen many many patients over the years complain about the tenderness, discomfort, and breast growth that just would not go away after stopping the "over the counter" pills. Medical treatment of gynecomastia works only on the swollen phase of gland stimulation by blocking the effects of the stimulating hormones. Once this swelling subsides, there seems to be little effect of medical management unless there is an underlying problem. The human hormone system is in a delicate balance that can be thrown out of kilter. Sometimes it can recover on its own. Other times, patients stop the stimulating agent and the tenderness and growth persists. If tenderness, growth, nipple discharge or other
Symptoms of Gynecomastia Growth continue, I ask my patients to have an evaluation by an experienced Endocrinologist. I have even seen patients who after cycling with self medication have untreatable continued breast growth. One particular patient had already had 2 major breast reductions by other doctors and regrew massive breasts after each operation. His endocrine system could not be reset, several endocrinologists were unable to find anything to change.
I prefer to operate on a stable problem whenever possible. If the breasts have stopped growing, are not tender, then surgery is an option. Otherwise you are risking breast regrowth.
I work with many
Bodybuilders with Gynecomastia. While bodybuilding is great for shaping muscle, it will not help with gland. One common complaint is as they build muscle, what sits on top of the muscle just gets pushed further out.
No Surgery Body Shaping Compression Garments are a great temporizing measure. They can give an instant contour improvement as soon as you put one on. The problem is, once removed, the original problem remains. However, as an emotional band-aide they are spectacular. You should see the expressions on patients in my office trying one on! Some use it while their problems are stabilizing. Others use the garments until they can afford the operation.
Liposuction Is Great for Sculpting FatVarious types of ultrasonic and power assisted liposuction (UAL and PAL) have been around for quite some time. Each surgeon uses the tools and techniques he / she prefers.
There are studies claiming that ultrasonic liposuction does not break down gland cells, these were done to justify the safety in female liposuction breast reduction surgery. Ultrasonic energy cannot be both ways, good for gland breakdown and safe not harming gland unless there is a difference between male and female breast gland tissue which has not been proven to my knowledge.
Tumescent liposuction is a form of anesthesia where fluid is placed in the tissues to be sculpted. You can see
very graphic pictures of the tumecent technique
here.
Liposuction such as ultrasonic, VASER, power assisted, and sharp cutting cannula preferentially remove fat over gland. Gland tends to exist under the nipple areola region. When fingers of fat extend between fingers of gland, breast reduction can come from removing the fat and leaving gland behind. On animation such as flexing the pectoral muscles or putting the arms over head, gland does not compress or move like fat.
When gynecomastia is from fat, liposuction works very well for contouring the chest. I have seen many patients from other doctors who tried to use liposuction alone techniques that left gland behind that the patients just did not like for
Revision Gynecomastia Chest Sculpture.
Here is an example of Revision Surgery after Liposuction alone.
Here is another revision after liposuction alone.I have seen just too many unhappy patients with puffy nipples remaining after axilla or armpit attempts alone using sharp cutting cannula or other such instruments by other doctors. Check out this drawing of
Puffy Nipple Anatomy after Remote Gland Removal Drawing.
The problem is picking the right method for what actually is that patient's problem. That is why I prefer my
Dynamic Technique that permits what I find during surgery to guide my sculpture. The incision at the edge of the areola opens up my entire spectrum of artist's pallet of tools for my sculpture. A remote incision robs me of many options and just does not looks as nice. I prefer to avoid this unnecessary additional scar.
I have also seen patients with channel problems between remote access sites and the areola / nipple. Scars, adhesion, and depressions can look terrible. Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexing
here to see what I mean.
Ultrasonic liposuction uses energy to help emulsify fat. Power assisted liposuction uses mechanical vibrating devices to rapidly move the cannula back and forth. Both PAL and Ultrasonic methods have been around for several years. Many do not prefer what they do to the tissue. Others like what they offer. Both still preferentially remove fat over gland. Both make the work of the surgeon easier. Some feel ultrasonic liposuction can cause more swelling, bruising, and the increase the need for drains.
For a liposuction cannula to remove gland, it can also remove connective tissue and other structures which can lead to more bruising and scars. I have seen so many patients who were unhappy from doctors that used "special cannula to remove gland," that I just prefer to go directly to the problem itself. Primary surgery is usually better than needing a revision. All male breasts have gland. With access to the gland directly, I can peel it off the areola muscle, minimize bruising and bleeding with direct control of the tiny blood vessels, and then reconstruct the contour.
For me however, they also both remove the feel of the tissue sculpture. I like the much better control I get with my cannula selection and personally I do not like either ultrasonic nor power assisted techniques. None of the cases on my website used either PAL, Ultrasonic, nor sharp cutting cannula techniques.
As any artist, I take my cannula selection
very seriously and have evolved what permits me to achieve my results. I have considered and evaluated many, many technologies. The many different types of cannula I use have their own advantages and qualities. I pick a subset of these cannula that varies for the many different types of gynecomastia male chest sculpture that I see.
Gland removal by any technique can still leave a depression when a major part of the problem is from gland. For gland removal, I prefer the greater precision of removal under direct visualization and feel. This also give me access to many more elements for my artistic palette of my
Dynamic Technique to sculpt the remaining tissues.
This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat. How tissues move is important. The human body is beautiful in animation. That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views. Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor. It is like an artist selecting a paint brush. The results are what matters, not with what tool they sculpt.
Hope this helps,
Michael Bermant, MD
Learn More aboutGynecomastia and Chest Sculpture
Topic: Can gyno surgery help me? (Read 5008 times)
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