Gynecomastia symptoms for 6 months

[guy1985]

I have had minor gynecomastia symptoms for 6-7 months, puffy nipples, from a prohormone I took last September for 1 month. Would medical treatment with tamoxifen still be an option to reduce gland? Also I have visited a few plastic surgeons who say that noninvasive laserlipo would tighten my slightly puffy nipples and improve their appearance. Basically I have very little fat and minimal glandular tissue around the areola. Could just burning the under layer of skin tighten and flatten my nipples.

[Dr. Elliot Jacobs]

Sorry to hear about your problem.  It is most likely due to prohormones.  

Best to immediately discontinue the prohormones and simply watch and wait.  Observe for any signs of change, such as increase in size, tingling, pain, etc.  If so, you might consider speaking to an endocrinologist to see if any intervention might be of help.  Would definitely NOT try to self-medicate based on recommendations from lay persons or from info available on the web.

Once your condition is stable and if it continues to bother you, then consider consulting with an experienced gyne surgeon to assess the situation and offer some solutions.

Please stay away from the laser lipo people.  First, laser lipo IS INVASIVE -- thy have to get under the skin somehow, right?  Second, burning the undersurface of the areolar skin will do nothing to get rid of the enlarged breast tissue which is the actual cause of the problem.  Third, you could conceivably get burns of the areola (from underneath) -- which would result in scarring.

Be smart!  "Smart Lipo" will not work for you.

Dr Jacobs

 

[Litlriki]

Just to add to Dr. Jacobs' comments regarding pro-hormones.  I typically recommend that patients be off of the pro-hormone supplement at least 6 months and up to a year before abandoning hope of spontaneous resolution.  Beyond that point, it's highly unlikely to improve, in which case surgery would be required to correct it.

Strongly agree--you should not try to self-medicate.  The "medicines" you consider using are often non-FDA approved supplements, and if they're drugs, they may not really be what you think they are unless you got them from a pharmacy yourself.  I have seen a number of patients who were worsened by their "estrogen blocker."

Rick Silverman

[DrPensler]

You should not resume the pro-hormone. Once there is significant glandular tissue development from steroid use it rarely resolves.I must note  that cases that resolve do not make appointments to see me but I have seen a lot of patients with your story.As far as laser lipo it is not effective for glandular tissue removal.Any correction that is not directed at treatment of the underlying problem ,ie increased glandular tissue from hormone stimulation, will not be effective.Tamoxifen will not be useful.

[guy1985]

Thank you for the replys, much appreciated!

I have been to two GP's and a plastic surgeon in the last few weeks. All said they could not feel any tissue change, no lumps. I also can't feel any lumps, have never had any pain, itching, tingling. The plastic surgeon said I may have had gynecomastia at some point, but now all I have is excess areolar/surrounding skin that is causing it to look like this, not lay flat. Because of this analysis I am wondering if I could lift weights to fill in the excess skin and possibly use a cream or castor oil to help tighten the skin.

Please see attached. I included a picture of each side when they are puffy/"normal". The two "pulled" pictures are me with improved posture (shoulders back) and slightly pulling up from the upper chest to flatten out the lower chest by lifting it up. First, do you think I have gynecomastia, or just remnants of excess skin? and do you think I could flatten this out with much improved posture, losing some fat (basically I am skinny fat and out of shape), and adding mass to my upper chest, shoulders and upper back?

Thanks

[Litlriki]

Based on the photos, the appearance of your chest is fairly consistent with your body composition (body fat), confirming your assessment as "skinny fat."  With that in mind, diet and exercise might indeed improve the appearance of your chest.  If you truly have gynecomastia, the nipple puffiness might persist despite weight loss (fat loss), and if that's the case, then surgery might be required to correct it.  But your plan of health improvement with diet and exercise may alleviate any need for surgery.

RS