Input appreciated.

[unoboob]

I am 23 years old and have unilateral gynecomastia that developed around the start of puberty, so over 8 years ago.  I have dealt with the condition throughout high school and college, so I've pretty much learned to live with it. However, my gyno does make me very self conscious and I've had surgery in the back of my mind for years.  I'm 5'9", 140 pounds, usually hover around 5% body fat and have no signs of pseudogyno. I smoke weed occasionally, but did not begin doing so until years after the gyno developed (don't worry I live in CO). I'm hoping people on this forum can help clear up some questions I have.
1. Does anyone have input on 'diet aid of questionable value' and/or other products of this type. So far as I can tell 'diet aid of questionable value' is a dietary/weight loss supplement that can help men dealing with pseudogynecomastia, which is intentionally misrepresented by the manufacturer as a treatment for gynecomastia. Can anyone confirm or contradict this?
2. I've discussed my condition with my doctor several times over the years and he has generally discouraged me from seeking treatment and has never run blood/hormone or any other tests. Should I seek a second opinion?
3. A couple years ago I noticed a pea sized lump on the side of my abdomen, my doctor says it's a fatty cist. I've seen it mentioned that the development of abnormal growths or lumps in combination with gyno can signal a more serious underlying condition. Should I be concerned?  
Any responses along the lines of "Your case is mild and you should just be glad it's not as severe as mine and move on with your life" are NOT welcome, because they are not constructive.
Thank you in advance for your responses!
*photos attached

[TomJones]

Perhaps a change of doctor is in order.

There are no diets (or pills) to reduce gynecomastia.  At 5% body fat, you are already at optimum.

A blood workup should be done and it should include a testosterone panel as well as an estrogen check.  At your age, a baseline should be established anyway.

Not to concern you, but any lump in breast tissue should be evaluated beyond a feel of the fingers.

Tom

[hammer]

I'm with Tom. You need to find a different doctor, get your blood work done.

Good luck.

Bob

[TigerPaws]

No question you have some breast development.

Find an Endocrinologist who is experienced with male breast development and have your hormone levels checked. Doctors are like everyone else, there is the good, the bad and the exceptional, never ever rely on one opinion because that is exactly what you will receive an opinion. Medicine is as much art as it is a science.

If you feel a mass/large round lump under your nipple (this can be fairly large so what you are feeling for is a hard mass which is the breast gland). As a reference search the internet for images/drawings of what a breast gland looks like.

If you feel an itching, tenderness/soreness or like a string is being pulled through the center of your nipple(s) that is a pretty positive indication of breast gland growth.

If your blood work comes back as normal then there is little that can be done except for surgery or to learn to live with it as many others have done.

[Dr. Elliot Jacobs]

Unilateral gyno is perplexing.  If the development was due to hormonal fluctuations, then why didn't both breasts respond to the hormones by both growing?  I admit, I don't know the answer.  You can/should have your hormones checked by an endocrinologist -- but I would bet they all come back normal.

What you describe on the side of your abdomen has no relationship to your gyne.

You are slender, have had stable gyne for 8 years and therefore would be a good candidate for surgery.  One caveat:  have the surgeon evaluate BOTH sides.  Sometimes, one side is greatly more enlarged than the other (and your attention is therefore drawn to that side) -- but there may still be some excess tissue on the "normal" side.  If you have surgery on just one breast, you may find that the previously normal side now appears larger.  Best to have both sides evaluated and, if needed, treated at the same time.

Good luck!

Dr Jacobs