Recurrence

[Mr. Puffy]

I have three questions.

Have any of you surgeons had patients that continued to smoke marijuana after surgery?  If so, did they report back any sign of recurrence whatsoever?  What about any other drugs?

[Litlriki]

In nearly 20 years of practice, I've only had a handful of patients who cited marijuana as a possible cause of their gynecomastia, and in most cases, it was more likely that the gynecomastia preceded their marijuana use (during puberty), but they had no other ideas for an inciting factor.  As a result, I've been unimpressed by the connection of marijuana and gynecomastia, and the mechanism whereby gynecomastia is caused by marijuana resembles a "Rube Goldberg" device--in other words, the physiology is rather contrived.  My feeling at this point is that this connection is more consistent with "reefer madness" than actual science.  I'm not sure what the other surgeons on the site think about this.  I'm curious if other surgeons have seen more or convincing cases related to marijuana.

Rick Silverman

[Dr Kapoor]

Hi Rick, I would tend to agree most cases that i have seen over the years involving the use of marijuana and gynecomastia are minimally related and the condition was present before marijuana use. I can recall one patient who was a very user of marijuana having the condition start after his use, but that's the only one. In many of my patients who use on a regular basis, i have yet to see a recurrence.

[Dr. Elliot Jacobs]

My experience mirrors that of Drs Silverman and Kapoor.  Although many places (texts, the internet, etc) implicate marijuana use as a cause of gyne, I have not seen much proof in my patients, either before or after surgery.

It would be nice to do a true medical study to ascertain a possible link (or to debunk the link) but that is impossible since marijuana is illegal is most parts of the country.

Dr Jacobs