Author Topic: They keep coming back?!?  (Read 4878 times)

Offline Majetich

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Alright, in May of 08 when right around my 16th birthday, I had a surgery to reduce/remove my gynecomastia problem, in the short term it was amazing, but then about 4 months later I noticed that they were coming back. Well the surgeon I went to was (is) a pretty great fellow, and he said give it a little while so that they could stop growing again, and he would perform the operation again, for free. So, I did, and in December of 09 I had the surgery a second time. Now on the verge of my 18th birthday, they've pretty much grown right back to how they looked originally, yet again. Why? Is there anything at all I can do to stop this, or help this at all short of another surgery?

DrBermant

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Ok, I had the whole reduction surgery thing in May, and the results were splendid. My plastic surgeon told me about a week ago that I should massage the region in order to avoid any real scar tissue build-up, and about yesterday I noticed that there was a bit of clear liquid that would come out when I pressed my fingers on the areola (?). I was told once that that generally happens when they are growing, and my question for you is, is this a sign that they are growing again, and did I just waste all of my money on a surgery?

Male Nipple Discharge is one of many possible Symptoms of Gynecomastia gland stimulation and possible regrowth issues.

Alright, in May of 08 when right around my 16th birthday, I had a surgery to reduce/remove my gynecomastia problem, in the short term it was amazing, but then about 4 months later I noticed that they were coming back. Well the surgeon I went to was (is) a pretty great fellow, and he said give it a little while so that they could stop growing again, and he would perform the operation again, for free. So, I did, and in December of 09 I had the surgery a second time. Now on the verge of my 18th birthday, they've pretty much grown right back to how they looked originally, yet again. Why? Is there anything at all I can do to stop this, or help this at all short of another surgery?

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 Revision Gynecomastia and Chest Surgery

Offline Dr. Cruise

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    • http://lagynecomastia.org/
Going to an endocrinologist for a medical workup would be a good place to start.
Dr. Cruise
Board Certified Plastic Surgeon
2081 San Joaquin Hills Road
Newport Beach, CA 92660
949-644-4808
Before and After Pictures
Types of Gynecomastia

Offline Majetich

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I've had the surgery twice, and they've grown back twice. I figured I'd try again after a year or two in hopes that they'll have stopped. I cut out all soy and caffeine, because my surgeon said that that can make it grow, and I work out regularly to build up muscle underneath, which was supposed to do something. Now, I'm getting those "growing pains" again after some 5 months of thinking that I've leveled out. What else can I possibly do?

DrBermant

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I've had the surgery twice, and they've grown back twice. I figured I'd try again after a year or two in hopes that they'll have stopped. I cut out all soy and caffeine, because my surgeon said that that can make it grow, and I work out regularly to build up muscle underneath, which was supposed to do something. Now, I'm getting those "growing pains" again after some 5 months of thinking that I've leveled out. What else can I possibly do?

As stated above unless a problem is stabilized, surgery does not prevent gynecomastia regrowth. This issue is a lot less rare than some doctors contend. I seem to have seen quite a few after surgery by other doctors. Yet, for my patients I operate on, recurrence is quite rare. This may be due to my targeting gland first. However, it may be due to the extended time we spend with each of our patients helping them getting the problem stabilized first and then educating them about the limitations of the operation.

Hope this helps,

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


 

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