Is there a chance of it coming back if I get a procedure?
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.
Such revisions are an art form and they take a great deal of skill to minimize the chance of complications. Check the link on the bottom of this post to see examples of such revision surgery to better understand what I mean.
Hope this helps,
Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery
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