gland tissue

[tomo25mcr]

I no i have asked this before but i am told a few different from different people which makes things complicated. IS THERE ANY WAY THE GLAND CAUSING GYNO CAN BE FULLY REMOVED??? during surgery obviously, my lumps are really pissing me off now summer is here, im trying to save but bills are high, i feel like if i knew it would never be able to return then it would be worth me getting in debt and paying for the op over time.

[tomo25mcr]

guess it cant fully be removed without losing my nipples eh, oh well just me dreaming lol

[headheldhigh01]

i think when they say some always remains it usually means small bits that are hard to neatly cut out, so it's kind of a risk disclaimer.  and some docs leave some in to prevent cratering.  but the fact most of it is gone improves your odds against it coming back.  in the majority of cases, where the hormones aren't too irregular, it's not a real concern. 

[tomo25mcr]

thanks for your reply

[PBC]

Removing ALL the glandular tissue is just about impossible from what I have been told. Glandular tissue in a male breast is completely normal, and all human males have it. Normally it is such a small amount that there is no effect on male breast contour. Now for us lucky fellas, that isn't the case. I can tell you with 100% certainty that glandular tissue can return even after surgery. There is a caveat to this however...as long as your hormones have stabilized and the condition has ceased progression, it is HIGHLY unlikey it will return. Unless of course you are one of those pinheaded cretins who display a total lack of common sense/intelligence and return to the very activities that made your gyne necessary in the first place. ( drastic weight fluctuations, chemical intake, etc..)

[DrBermant]

I no i have asked this before but i am told a few different from different people which makes things complicated. IS THERE ANY WAY THE GLAND CAUSING GYNO CAN BE FULLY REMOVED??? during surgery obviously, my lumps are really pissing me off now summer is here, im trying to save but bills are high, i feel like if i knew it would never be able to return then it would be worth me getting in debt and paying for the op over time.

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.

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 of gynecomastia, when possible, is much better. We help patients explore such issues during consultations or preliminary remote discussions.

Hope this helps,

Michael Bermant, MD
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