Surgery during adolescence

[forwday]

Hi.  My 18 year old son appears to have Grade 1 gynecomastia.  Has had the symptoms for 4 or 5 years.  We assume it came on as a result of either his eating disorder (which he had from age 10 to 15) or the medications he was given while he had the E.D. (including Risperdal for about 6 weeks, and Zyprexa, for a longer period of time).  He saw a endocrinologist last summer who put him on Tamoxifen for 4 months.  There was a decrease in puffiness for about 6 months, but the medication didn't seem to have a lasting effect.  MY QUESTION: We have been advised by that endocrinologist as well as my son's pediatrician (neither of whom deal with many cases of gynecomastia) that he should not consider surgery until he is in his early 20's.  The (terrific) information on this site suggests that there's no need to wait, and, of course, there are advantages to having the surgery when the skin is at its youngest and most supple.  Should he wait?  Or is he a good candidate for surgery now?  Thanks.

[Dr. Elliot Jacobs]

I strongly disagree with your pediatrician.

If your son has had gyne for two years or more, and it is stable, then there is no need to make him wait unnecessarily until the magic age of "his 20's."

I have successfully operated upon hundreds of teens with gyne -- ant to this date, not one of them has had a recurrence of his gynecomastia after the initial surgery.

Dr Jacobs

[Dr. Schuster]

I also disagree with your Pediatrician. I am a strong advocate of early intervention. If the gynecomastia does not regress after 2 years max, it won't. Surgical correction is extremely successful and safe. There is no reason for any young man to have to "suffer" the psych-social issues that come from having gynecomastia (this of course assumes that it is an issue for the young man to begin with).

[Litlriki]

I would agree with Drs. Shuster and Jacobs. Teens as young as 13 or 14 can successfully undergo surgical correction with permanent improvement in the appearance of the chest if the condition has been present for more than 3 years, in which case it will not resolve on its own.  There is no need to wait until a man is in his 20s, and many years of embarrassment and inconvenience are avoided. 

[Dr. Cruise]

Based on the history you provided about your son's condition, there is no need for him to wait to have gyne surgery. It sounds like he has suffered enough at such a young age with his eating disorder and now enlarged breasts. I have performed countless gyne surgeries on young men with life changing  results both physical and emotionally. As others have said, surgery provides permanent improvement. Of note, it is important you seek out a plastic surgeon who specializes in gynecomastia surgery. 
Best of Luck!