Gyno after surgery and trt

[Tn198989]

Hello, 

I very been struggling with this issue for more than 10 years now and I could really use some guidance. 
After steroid use I got painful gyno in 2011.no hard lumps. Just puffy nipples and pain. 

In 2012 I got surgery to remove the glands. 
The result was saggier breast with nipples facing a little downwards. Puffy nipples remain to this day. 

Ever since the surgery I could feel a tiny lump above my left nipple to the left. Like the tail of gyno. 

Now I am on trt for a couple of years and suddenly after starting hcg that dreaded pain came back. I started nolvadex 40mg the day it started and now it's been one week and I still got pain on my nipples and at that lump I mentioned earlier. 

is that clear sign that there is breast tissue there or could it be scar tissue? 

how long do you think it can take for nolvadex to stop the pain and progression? I don't see anything visually different and the lump feels slightly larger but I could be wrong. 

Can that lump if it's the only leftover increase so much to cause recurrence? 

And lastly although wishful thinking can nolvadex help with the puffy nipples that remained after the first surgery? 

Thanks in advance

[Miguel Delgado MD]

The fact that you are having trt and HCG treatment can start the growth.  Nolvadex may or may not help. However, it is something you can try. You should be under a knowledgeable doctor's care to manage such a complex issue.