The real cause before surgery

[turtle78]

Hello again.

I have a question.  I've been seeing my primary and endocrinologist for a few months now.  I have very painful gyne.  Cosmetically it's more prominent on the right side.  The cosmetic issue doesn't bother me as much as the 24 hrs a day pain.  I'm 31 yrs old and started seeing my Dr. for this about 1.5 years ago.

Anyway, after doing all the necessary bloodwork, the only things standing out is my testosterone, 3 different tests had total results of 267, 74, and 340.  The last is low normal but all very low for my age.  I have a slightly higher than normal cortisol, and low vitamin D.

I'm looking into surgeons now, making a consultation appointment with Bermant....Do most people on here have the surgery without finding the EXACT issue?  Like everyone else I'm a little concerned that nothing is standing out to bad and the root cause will continue after surgery.

Any thoughts are appreciated.

Thanks

[Jake]

Most cases that are treated by surgery are usually for cosmetic purposes.  It's not common to find someone saying they had surgery to reduce pain they feel in their BREASTS.  Some men have complained about back pain due to overly large breasts.  I've never seen anyone have the problem you're describing.  Perhaps there have been some complaints about it.  I'm not sure though.

I honestly would see what your doctor says about surgery and really consider the options.  The pain could be a whole other issue.  Talking with Bermant will hopefully provide you with some relief.  Maybe he can shed some light where your Doctor (or Endocrinologist) cannot (although I don't know how he would).

I knew my case of gynecomastia was purely caused by puberty and the hormone fluctuations attributed to it.  There seemed to be no other leading cause because I wasn't taking any chemicals to cause the G.  It could have been genetic but I don't know.  It has not returned though in any case.

If I had physical pain, I would want to get that checked out and get the cause before I had surgery.

[DrBermant]

Hello again.

I have a question.  I've been seeing my primary and endocrinologist for a few months now.  I have very painful gyne.  Cosmetically it's more prominent on the right side.  The cosmetic issue doesn't bother me as much as the 24 hrs a day pain.  I'm 31 yrs old and started seeing my Dr. for this about 1.5 years ago.

Anyway, after doing all the necessary bloodwork, the only things standing out is my testosterone, 3 different tests had total results of 267, 74, and 340.  The last is low normal but all very low for my age.  I have a slightly higher than normal cortisol, and low vitamin D.

I'm looking into surgeons now, making a consultation appointment with Bermant....Do most people on here have the surgery without finding the EXACT issue?  Like everyone else I'm a little concerned that nothing is standing out to bad and the root cause will continue after surgery.

Any thoughts are appreciated.

Thanks

Real Symptoms of Gynecomastia can be critical for diagnosis.  Actually breast pain can be caused by hormonal stimulation of the gland.  When both pain and breast growth are occurring, a good endocrinology evaluation is very important.  I have seen many patients with such symptoms.  When a cause can be found and stabilized, there is a much better chance to minimize recurrence.  Sometimes the pain is due to physical trauma, such as constantly pinching the nipples to flatten them.  I have had patients relieve that symptom of discomfort just by wearing a body shaping compression vest.

Unfortunately for most, their gynecomastia happened long ago and other than speculation, idiopathic (no known reason) is the most common situation.  We are happy to help you explore your concerns.  Jane is my office manager and can explain the process.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.  At the time of the evaluation, copies of your work up and doctors' office notes and lab values can be of great value.

Hope this helps,

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

[turtle78]

I appreciate the responses.  While the pain is nonstop, and has been for some time, I don't notice a change in the appearance of the chest.  My concern is that I've been getting the full exam from my endo, and besides the lower testosterone, nothing really stands out.  Maybe the testosterone is it...who knows.  I've had about 6 blood work ups over the last month just to make sure we cover everything.  The endo that I'm going to in Maryland actually referred me to you Dr. Bermant.  I will be making an appointment to come down to Richmond for a consultation.

[DrBermant]

I appreciate the responses.  While the pain is nonstop, and has been for some time, I don't notice a change in the appearance of the chest.  My concern is that I've been getting the full exam from my endo, and besides the lower testosterone, nothing really stands out.  Maybe the testosterone is it...who knows.  I've had about 6 blood work ups over the last month just to make sure we cover everything.  The endo that I'm going to in Maryland actually referred me to you Dr. Bermant.  I will be making an appointment to come down to Richmond for a consultation.

We look forward to helping you better understand your options.

Michael Bermant, MD
Learn More About Plastic Surgery