Author Topic: Please tell me how bad this is?  (Read 5173 times)

Offline q8

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My gyno has developed over the span of 3 months. I got these lumps the size of a grape on both sides. There is also some fat. Understand that the fat is situated in my lower chest area only. My upper chest is all muscle however.
« Last Edit: June 29, 2014, 06:35:03 AM by q8 »

Offline Dr. Elliot Jacobs

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It would be best if you post some better photos -- preferably taken by another person.

Also, please elaborate on what supplements, if anything, you have been taking over the past several months.

Dr Jacobs
Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
4800 North Federal Highway
Boca Raton, Florida 33431
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Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.c

Offline q8

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Will do so in a couple of minutes, thank you for the fast response.

DrBermant

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My gyno has developed over the span of 3 months. I got these lumps the size of a grape on both sides. There is also some fat. Understand that the fat is situated in my lower chest area only. My upper chest is all muscle however.

It is very hard to evaluate photographs as you have posted. Try following the instructions on my Standard Pictures for Gynecomastia Evaluation. Print out the instructions and you will find:

using a mirror reverses the sides
holding the camera with one hand  can obscure the chest and adds its own element of asymmetry
you are missing key views that really show details of the problem.

Gynecomastia comes in many different degrees. Even subtle Puffy Nipple Gynecomastia can distort the cut look of a male chest.

Gynecomastia that is currently developing that started just 3 months ago often needs to be evaluated by an endocrinologist. Surgery does not stop breast growth. Getting a problem defined, then stabilized is the best method to minimize the risks of breast regrowth after surgery. This problem does happen, but remains exceptionally low for my patients.

Hope this helps,

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

Offline q8

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« Last Edit: June 29, 2014, 06:35:14 AM by q8 »

DrBermant

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Now look at the difference in the two sets of images. Does the second set represent the problem, especially when your nipple areola are relaxed? There are hints that there was more puffiness in the first set. That is why taking the pictures when relaxed in a warm room can reveal a contour problem. For some even subtle Puffy Nipple Gynecomastia is a contour problem that they do not like. Many of my patients with a D cup male breast would kill to get a chest looking like yours. Yet, even patients with subtle contour problem such as this Competition Bodybuilder with Gynecomastia are bothered by it bad enough to consider surgery.  This contour concern is a personal issue, each person sets their own comfort levels.

Hope this helps,

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

Offline Dr. Elliot Jacobs

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Thanks for the photos -- much appreciated.

It does appear that you are muscular and that you have a mild case of gyne -- but this would ultimately have to be confirmed by a hands-on examination.

Now you have to find out why this developed only in the past few months.  If you were taking supplements, then they may be the cause.  If not, then would suggest an endocrinological evaluation to see what might have started the process.

Do you have tingling, tenderness in the breasts?  This might be signs of growth and def indicate that surgery should be held off until the cause is determined.

Dr Jacobs

Offline q8

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Thanks for the help doctors. The reason I got gyno was because I used steroids. I've currently stopped since a few weeks ago and started using PCT, or in other words anti estrogen products. Problem is, I thought that this would take care of the gyno, but I was wrong.

I'd rather remove the gland and suck some fat out, so that this problem can never occur again.

On a side note, I went to the hospital and they said they'll do it for free. I'm Kuwaiti and we're given free health care. I'm scheduled to see a specialist in about 5 weeks. The doctor that examined me said it was a minor case, and that if I wanted surgery for it, it would be considered purely cosmetic. I made up some excuse that it hurts to sleep on my chest, anyways he said that it's fine, and that even if it's a cosmetic issue only, they'll go ahead and operate.

I know that Kuwait generally has well trained doctors, but i'm still kind of worried about the doctor that may be operating on me, messing up my chest either by leaving scars or cutting out muscle or some other horrible thing that can happen.

Edit: Yes DrBermant, the reason the second set looks not as bad, is because of the room temperature. When it is hot, they puff up and protrude really badly, when it's cold it's not noticeable and my chest looks great.
« Last Edit: March 11, 2010, 08:52:47 AM by q8 »

Offline Dr. Elliot Jacobs

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It would be wise to be off any and all supplements -- those you took to diminish what developed are obviously the wrong thing to do.

If you are in the US, there are many excellent gyne surgeons across the country.  I would very strongly advise you to seek someone who has particular expertise in gyne surgery -- it can be a difficult operation and if done poorly, you will be in the situation of trying to get things fixed -- and that is always playing catch-up.  Visit several doctors, check their credentials, their before/after photo collection (it should be extensive in gyne photos) and then decide based on which doctor you feel most comfortable and confident.

If you are in Kuwait, my same precautions are advised.  There are some men from the middle east who have posted on this forum.  Why not send them a personal message and ask who did their surgery and if they were satisfied?

Your last alternative is to travel to an expert.  If you wish, I would be pleased to provide a free email consultation for you.  I have many men who travel to see me from all over the world, including many from the middle east.  Send me a personal message with your name and email address and I will send the info to you.

Whatever you decide, best of luck!

Dr Jacobs

Offline q8

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Thank you doctor. Well the thing is regardless of whether or not the gyno developed, once a steroid cycle is completed, anti estrogen products, such as aromasin, and estrogen blockers such as nolvadex are used to help bring back natural testosterone production.

I'll go back to the hospital tomorrow and double check. It might be possible for the government to pay for me to travel abroad and get the surgery done.

DrBermant

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Thanks for the help doctors. The reason I got gyno was because I used steroids. I've currently stopped since a few weeks ago and started using PCT, or in other words anti estrogen products. Problem is, I thought that this would take care of the gyno, but I was wrong.

I'd rather remove the gland and suck some fat out, so that this problem can never occur again.

On a side note, I went to the hospital and they said they'll do it for free. I'm Kuwaiti and we're given free health care. I'm scheduled to see a specialist in about 5 weeks. The doctor that examined me said it was a minor case, and that if I wanted surgery for it, it would be considered purely cosmetic. I made up some excuse that it hurts to sleep on my chest, anyways he said that it's fine, and that even if it's a cosmetic issue only, they'll go ahead and operate.

I know that Kuwait generally has well trained doctors, but i'm still kind of worried about the doctor that may be operating on me, messing up my chest either by leaving scars or cutting out muscle or some other horrible thing that can happen.

Edit: Yes DrBermant, the reason the second set looks not as bad, is because of the room temperature. When it is hot, they puff up and protrude really badly, when it's cold it's not noticeable and my chest looks great.

Free is worth the price only if they do it well. I have posted here How to Pick a Gynecomastia Surgeon:

http://www.gynecomastia.org/smf/index.php?topic=16474.0

I have seen many patients from Kuwait and around the world who prefer my technique. To minimize travel, most start out with my Preliminary Remote Discussion.

Being patient can be quite important. With a cycle that is not properly suppressed, gland can be stimulated swell and enlarge. It can also grow in size. Once the swelling goes down, the damage can be better assessed. For some after the swelling subsides, there is little contour deformity. For others, what has grown remains a problem.

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. 

However, for someone who is only 3 months into breast growth, the answer is being patient and possible Endocrine evaluation. If it goes away on its own the results will be better than any surgeon's scars.

Hope this helps,

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

Offline q8

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However, for someone who is only 3 months into breast growth, the answer is being patient and possible Endocrine evaluation. If it goes away on its own the results will be better than any surgeon's scars.

I have lumps the size of grapes on each side, can this possibly go away on it's own with the use of anti estrogen, and estrogen blockers? I know that gynocomastia induced from steroids has a higher possibility of being reversed through these types of medications from what I read, but when the lump is this big, is it still possible? And is there an estimation on how long it would take?

Edit; On a side note, I ran a minor cycle before to help me lose some weight, I was very lean last summer. Anyways I got some smaller lumps, on one side, they went away after about of month of using nolvadex and aromasin, but now I have much bigger lumps, on both sides, which I don't think will go away for a good while.

Again, I really appreciate the fast responses doctors, great public service you are providing here.
« Last Edit: March 11, 2010, 10:08:38 AM by q8 »

Offline Dr. Elliot Jacobs

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Certainly there is no rush for surgery.  However, it is my opinion that chasing medications with other medications to counteract the side effects of the first medication is a fool's errand.  You are messing with your very delicate hormonal system.

Best advice is to give yourself time to let everything stabilize and subside as best possible.  Most breast tissue which has been stimulated by hormones or supplements will not disappear entirely by itself.

When your condition is totally stable, and if you still have residual tissue, then you should consider surgery.

And by the way, some doctors charge for an email consultation -- and they may not do it well either.

Dr Jacobs

DrBermant

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Quote
However, for someone who is only 3 months into breast growth, the answer is being patient and possible Endocrine evaluation. If it goes away on its own the results will be better than any surgeon's scars.

I have lumps the size of grapes on each side, can this possibly go away on it's own with the use of anti estrogen, and estrogen blockers? I know that gynocomastia induced from steroids has a higher possibility of being reversed through these types of medications from what I read, but when the lump is this big, is it still possible? And is there an estimation on how long it would take?

Edit; On a side note, I ran a minor cycle before to help me lose some weight, I was very lean last summer. Anyways I got some smaller lumps, on one side, they went away after about of month of using nolvadex and aromasin, but now I have much bigger lumps, on both sides, which I don't think will go away for a good while.

Again, I really appreciate the fast responses doctors, great public service you are providing here.

I prefer to defer medical management to an experienced Endocrinologist. Sometimes they ask me to hold why they try medications for current swelling issues. At other times they give a green light to proceed with surgery. The problem with cycles is that they can grow gland well beyond just a swelling component. That growth just does not seem to be well managed by medications alone.  However, such issues are best explored with the Endocrinologist instead of self medication.

Hope this helps,

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

Offline **Gynefor**

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Considering your first set of pics, the last picture showed some signs of gyne, the profile view especially. But the last photos you showed do not show, in my view, an important case of gyno. You may have a slight bit of gyno but to be frank, it is hardly noticeable. All I can see is a perfctly well built body and chest, nothing I would be ashamed of or what so ever... I think that, like me, you have it but it is not THAT important to consider surgery. Unless you are really concerned by it and you don't feel well with your chest, then consider surgery but otherwise, do not.

 

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