Just to clarify...Are you saying that losing too much weight (or reducing oneself to a weight they are not comfortable with) before surgery can be equally as bad ?, in that if the weight (or more likely or even inevitably when) gets put back on (or even some of it), that it may have a tendency to be deposited in the chest area?
Is what you're saying that it's better to arrive on the day of surgery at a weight that one is comfortable with, rather than one that is too low for the individual (that they have reduced as much as possible,in the hope of gaining as flat a chest as possible, if based on a generalised fat pinch-test ) to maintain comfortably in the long-run ?
Yes, getting to a weight you are comfortable with minimizes the gamble of how weight will be gained or lost. Gynecomastia surgery does not prevent weight gain nor weight loss.
That's my understanding of it. He's saying guys tend to gain the weight in the chest and stomach area. That's certainly where I gain it.
Personally i'm not convinced it's equally bad to go to surgery too skinny vs. too fat, but i suppose neither is healthy.
Sure, if a guy allows himself to get fat again it can go back to the chest. Especially if hormones are not stable. Kind of a non committal, catch all type of answer. I guess people can go to both extremes before or after surgery.
Dr. Bermant - Do you advise your patients to see an endocrinologist prior to surgery?
We do have an extensive series of screening questions that endocrinologists and other specialists have helped us evolve. A patient who has
growing breasts or significant issues
IS Referred for further evaluation. The problem is that it is
NOT a single blood test. For some of our patients it can include MRI's, biopsies, and a gradation of lab tests based on initial studies.
Take a look
here at the large number of possible problems that can cause gynecomastia. For some patients who did have growing breasts before surgery and were referred, the tests can be very extensive and what tests are needed can vary from patient to patient.
Here is one patient who I referred for an evaluation. Other doctors had missed it, but he had Klinefelter's Syndrome that my examination and questions revealed. I eventually did perform the surgery after his condition had stabilized under appropriate treatment.
Unfortunately, of the many many patients I have referred for endocrinology over many years, the vast majority come back with idiopathic or unknown cause for the gynecomastia. I recently saw one patient who grew breasts back each time after 4 operations by another doctor. An extensive endocrinology evaluation was negative. That endocrinologist discussed the case with others who also came up with no cause. The patient was then referred to a world renowned endocrinologist who also could not find out why the breasts were still growing.
When patients have problems of continued breast growth, they may not be candidates for surgery. There have been patients who were not stable and surgery was not recommended by me.
At other times, like with a teenager cursed with massive breasts,
early surgery may be a life changing important change even if there is a risk of further breast growth. Such patients frequently are already worked up by endocrinologists before being referred to me.
I encourage patients who are concerned about the cause of their gynecomastia to have an evaluation by an endocrinology specialist who is aware of the many possible causes of male breast growth before surgery. That way appropriate tests can be ordered. The testing may be simple or complex but what testing is done is selected by the endocrinologist. However, such testing will not prevent future breast growth.
Many medications can also cause gynecomastia. For many, the medications have more value than the possible issue of breast growth.
Hope this helps,
Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture
Topic: Dr. Bermant - Please Help? (Read 3503 times)
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