heart ache

[sammi]

I really hope I can get some encouragment here. I'm Sammi and my son Tre is who my heart aches for.  I will begin telling you my son is 9 years old, active in dancing, choir, and basketball.  He is a handsome, smart young man.  Tre was about 5 when he grew over night.  His height/weight skyrocketed!  I didn't think much of it. At a routine doctors visit I showed the doctor Tre's chest area and he assured me that it was just baby fat and that he would grow out of it.  Four years later here we are....About 6 months ago a new doctor refered me to our local childrens hospital after just a glance of Tre's chest area.  We have had test and blood work done and the latest is that his estro levels are at a very high rate and this is the cause of the gynecomastia.  We now have two more test to complete before any medicine can be perscribed.  We were also told today that he will need surgury to remove the breast tissue.  My baby is devestated!!!!  He cried so much!  He told me things like mommy you said you would never let anyone hurt me and surgury will hurt me.  He said I don't love him and that is why I told the doctor that he can have the surgury.  He even said that he wants to run away!  I told my baby that I want this for him because I am tired of cruel children picking on him, they always call him tiddy boy.  He tells me mommy if they say that to me they are not my friends.  He even has kids that come to our house who seem to be good friends call him this when they get mad.  Just last week at the park a boy a few years his elder walked up out of no where and grabbed his chest and said damb your titties are big.  People are so cruel!  I think this is whats best for him and that one day he will be happy with my decision because as a mother I want to protect him and I can't always br there to do that, but I don't want him to think that I don't love him the way he is and that he isin't bright enough to make this decision on his own.  I do believe that all his fears are in the pain of surgury and that he dosen't fully understand my reasoning, although he did say that if this would cause him to be sick, or in his own words to die that he would have surgury.  Please someone give me some advice!!!

[getrippedordietrying]

Your story is very touching... I personally believe that you should take your child into surgery. Being a teenager right now and having the condition since i was about 12 has been extremely hard...the constant teasing and being afraid of whut my school friends or girls will think about me. I would reccomend taking him in. because he will be mad at you for only a few days and if u can battle through that it will be much easier than dealing with a depressed child who has been shunned by the student population... I think u have to look at this situation like a trip to the dentist.... your kid maybe upset with you but in the end you may save his dignity and possibly his life.

[sammi]

Thankyou so much for the information.  I am at a stand still. You see I see both of your points.  I will tell you that in the doctors eyes that even when he hits puberty this will not shed itself. His estro levels are at 59 and the recomended amount is 4 to 5 with a 10 being the higest.  His condition is contained to the one area also and and this alarms the doctor because it is very contained to the area and hasen't spread to any other area of his body.  They assured me that the surgury is the only way.  Now to the young teenager who said to have the surgury, I see a point in the trip to the dentist.  You see not only does my son get made fun of by the name calling, they also call him gay.  He acts out sometimes as well. The doctor said that this could be because he trying to get a laugh from others instead of being laughed at.  I still don't know.  Then I have a co worker whos son at 17 just had surgury before going off to college and she said that if he would have known about the options sooner that she is sure he would have wanted it sooner.  The doctor did say that I could wait a few years if I wanted to but I question what is that doing for my child.  Last month we visited a small water park and it was a rainey day, there were a few people there mabey 10 and the kids were under the age of 5, we went with all family members about 8 kids, cousins.  The place didn't allow t shirts because of the filter system and Tre refused to get in the water.  He said he would just sit out all day.  We were there at 10 am and were staying till close at 7.  Even though we were family and the strangers were young kids, he refused.  I was able to go to walmart and get him a shirt made of mesh that the pool allowed but at 9 years old you shouldn't know what physical imperfections you think you may have, you should just know about being a kid.

[Grandpa Bambu]

You see not only does my son get made fun of by the name calling, they also call him gay.

Kids calling each other 'gay', is part and parcel of being a kid and growing up.

Sometimes, non sufferers will consider the sufferer of Gynecomastia a homosexual, as a result of having a 'female' characteristic. This is very unfortunate for sure. However, having Gynecomastia does not mean that you are 'gay'.

I am sure that the Gynecomastic sufferer will, at some point, question his own sexual/gender orientation. Am I a male? Am I female? Am I both? Am I homosexual? 'What' am I? Being a teen and going through puberty is confusing enough, let alone having to deal with such burdens.

Last month we visited a small water park and it was a rainey day, there were a few people there mabey 10 and the kids were under the age of 5, we went with all family members about 8 kids, cousins.  The place didn't allow t shirts because of the filter system and Tre refused to get in the water.  He said he would just sit out all day.  We were there at 10 am and were staying till close at 7.  Even though we were family and the strangers were young kids, he refused.

To the sufferer, it does not matter who it is, Mom/Dad, other family members, strangers who he'll probably never see again, he cannot bear the thought of someone else seeing his hideousness. Many Gynecomastic sufferers view themselves as being a 'freak of nature'. Many believe that they are the 'Only One' with the debilitating condition, and unfortunately, suffer in silence. However, with the advent of the Internet, sites such as this, are truly a godsend. The sufferer comes the the realization that in fact, they are not the 'Only One' and that there are others who have the condition. That fact alone, is very comforting.

My heart goes out to you and your son, and anyone else for that matter, who sufferers from this psychologically debilitating condition. At this stage of your son's life, I would suggest following the direction of your medical professional. For the most part, doctors know best after specific testing has been done. Surgery sounds like a must, however as maywest mentioned, the estrogen level issue must be resolved prior to any surgery. Or.... you run the risk of the Gynecomastia returning.

You mentioned that Tre had a sudden growth spurt when he was 5. I'm sure there is a connection between sudden growth spurts and Gynecomastia. When I was a teen, I had a 'sudden' growth spurt. I was shorter than most up until about 14 or so and then I suddenly put on height. I went from approx 5' 3" to 6 foot very quickly. I once ran a poll here on Gyne.org about 'late bloomers' (in Tre's case, early bloomer, however much the same issue). Many of the poll respondents were in fact 'late bloomers' and had very quickly put on size and height.

GB

[sammi]

I am still so lost, all I can do is cry.  I want to help my baby the best way I can.  I spoke to the doctor today who told me that we could probable get in before school starts in mid August.  I don't know if thats to soon or if I should wait and let this all sink in for him first.  In response to the question of stabelizing the hormones, well they do have a medicine that he will continue to take untill he hits puberty and then he will be retested after that.  They are going to do an ultrasound to determine if there are any sex cord tumors causing the hormone levels to rise.  They did tell me that once removed they wouldn't come back as long as he takes the medicine.  But is my baby to young to take medicine everyday for the rest of his life?  I am so confused.  Then I think wait but thats another year of ridicule for him.  I only want to do whats best.  I don't want to hurt my baby.

[Mr_Nip]

I was around 8 or 9 when my gyne became severe.  I remember those cruel comments as if they happened yesterday.  What I do know is that he's in a lot better situation than I had because he's got you on his side.  He know's you're out there trying to find a solution, and that there is somebody he can confide in.  Keep up your good work and communication.  I don't know what to tell you about surgery at a young age.  Though many here would probably disagree with me, here's my gut feeling:  If you feel strongly enough about surgery, then maybe the gyne won't come back.  If it does come back later on though, then would you support having another surgery at, say, age 17?  If so, then I believe the early surgery could be a great benefit to a child suffering severe gyne.   If my son were to get gyne half as severe as I had it at age 9, then I wouldn't hesitate to get the surgery for him.  I'd consider it an acceptable risk that I'd have to pay for it again in a few years. 

[sammi]

Thanks alot Mr. Nip, I just had a discussion with my son and for the first time he seems to have a little understanding as to why I want him to have this surgery.  He is terriffied!  He ask questions like how long the surgery will take.  I think I'm making the right choice.  I have one question...people keep saying that it may come back but the doctors never mentioned this.  They said that the medicine he will take will stop the production of estro untill he hits puberty where at that time he will not take the medicine again, after puberty they will test his estro levels again and then if the levels are still elevated he will continue on the meds and if not he will not take medication.  Does this seem accurate?  Does anyone know something to be different?  I wish I had a picture to share with you all, your heart would melt!  My son is at least a c cup, they don't sag at all.  They sit strait up.  He wears large shirts, nothing helps.

[Mr_Nip]

...people keep saying that it may come back but the doctors never mentioned this.  They said that the medicine he will take will stop the production of estro untill he hits puberty where at that time he will not take the medicine again, after puberty they will test his estro levels again and then if the levels are still elevated he will continue on the meds and if not he will not take medication.  Does this seem accurate?  ...

I assume that the medicine you're talking about will balance his hormones to somewhere close to normal until he is at an age that his hormones achieve a normal balance naturally. 
I would feel much safer doing the surgery at an earlier age if the hormone levels are being monitored and controlled.  Out-of-balance hormones are what can cause gynecomastia to reappear after a surgery.  If the hormones are kept in balance by medications, then it would stand to reason there'd be less of a chance of the gyne coming back.  What I'm saying is it makes sense to me, but then I'm not a doctor. 

[neenos]

Reading this my heart goes out to you. Being a young kid getting teased at school is a complete nightmare for a child, he's surrounded by his peers who most would tease him in an instant if they think it will make them look "cool" in front of classmates. I also commend you for actually taking this situation seriously as it has a psychological effect down the road as it continues.

Your doing great talking to him about his condition and informing him about surgery. Every child has a fear of surgery, they're intimidated because they don't know how it works. I think if you keep talking to him about it he will be less fearful of the procedure.

This reminds me of a story/patient I stumbled upon when I was researching my plastic surgeon. The story is about an 11 year old girl with the left breast that grew irregular and became quite large. I can't fathom what a young girl would go through with this kind of condition. Being alienated from her girlfriends and prospective boyfriends (They start young these days).

If you want to see the pre & post op pictures of this story click on the link below:

http://www.theplasticsurgerygroup.net/photo-gallery/details.cfm?ID=372&IMAGEID=700&StartRow=26

[sammi]

You guys are really great I am so glad I found this website and all the support that comes along with it!  I think my mind is made up.  Can anyone tell me a typical surgery recovery time frame?  I don't want to rush anything at all but if I can get him in before school starts the year will be much easier on him.  My son has been asking me alot of questions this evening, he's trying acceptance on for a change!  He ask typical 9 year old questions like how long untill he wakes up and the medicine wears off.  He will be ok for that I will pray.  I myself however have quite a few questions.  You see with this surgery being a referal from the endo. doctor we are binded to use a surgeon at texas childrens hospital and I never having been through the process dosen't know if I take who they reffer me to or do I look at other options.  I will say that whomever it is will be a pediatric surgeon and I will request info. on if and when this procedure was done prior to ours.  The hospital is one of the best.  Another question is pain and discomfort for my son.  And what about contact?  I read about a boy who wore his vest 6 months after surgery.  Will my son need to wear this to school?  Can he go out and play or is he in bed for 6 weeks?  I have a mixture of thoughts and feelings running through my head !!!  I am excited because it's a fresh start for my baby, scared for him and the pain he will encounter, nervous about any risk involved, and oh so sad that he even has to face such things in life and especially at 9.  I am glad to know there are people here that I can talk to.  I think the doc was impressed when I told her I did some homework!  I was a little shooken well alot shooken when I recieved the news from the doc yesterday...could I have done something different?  My baby needs something that I can't fix...If anyone has ever known of a child this young having the surgery, seen, read something, please let me know.  I will listen to all suggestions!  Thanks again to all.

[sammi]

Here are a few shirt on pics. These are noticeable and they are old pics as well, some a year and a half old.

[sammi]

here are a couple more

[Mr_Nip]

I can see that you are looking in the right direction.  Other kids, and adults too, can be very hurtful to a kid with severe gyne.  My chest was similar in shape to his at that age all the way to age 42.  I've heard all the hurtful comments over and over again.  If you can save your son from that, then you're a hero.

PAIN?  I had two of these surgeries (one big one to remove gland, fat, and resize areolas, and one revision to remove some extra fat and fix a little dent).  Neither of these surgeries gave me any major pain.  I still have all but one of the oxycodone pills they gave me for post op.  I took that one right after surgery just in case I started hurting after the anesthesia wore off.  The only time it hurt was when I raised my arms up high.  The compression vest was a pleasure to wear right after surgery because there was some discomfort by not wearing it.  It helped hold everything together where my extensive lipo was done.  The light compression t-shirt (Underworks) was recommended a couple of months for me. 

The biggest concern going forward is quality of surgeon.  I would push to get a surgeon who's experienced in MALE breast reduction surgery.  Make sure that gland tissue is removed as well as fat.  Yes, gland tissue is a major factor in gynecomastia, but some doctors still refuse to believe it.  By the way, liposuction will NOT remove any gland tissue.  It has to be cut and pulled out.  Are his areolas big and rounded as well, possibly shrinking in when stimulated by cold or touch?  If so, then that's a classic sign that excessive gland is pushing out and making the puffy nipple look.  If the areolas are extra big, then they can be reduced, too.  These are the things you need to be finding out at this point.  If your surgeon doesn't understand any of these points, then you should push hard to find another surgeon. 

[Grandpa Bambu]

The biggest concern going forward is quality of surgeon.  I would push to get a surgeon who's experienced in MALE breast reduction surgery.

100% agreed...

You do not have to go with the surgeon that your Endocrinologist refers you to. The surgeon at T.C.H, who you were referred to, may not have any, or very little experience with GRS. Choose a surgeon who has excellent credentials and performs GRS frequently. There are a few guys here that have had their surgery done by an excellent PS in Texas. Can't recall the name right now though. Will have to do a search for you.   

Make sure that gland tissue is removed as well as fat.

Another good point!  Many PS's shy away from excision and do 'Lipo only'. Many 'Lipo only' procedures do not achieve the results that the sufferer is seeking. I have only heard of one instance of a sufferer who had lipo only and was totally satisfied with the results. For the majority however, a peri-areola incision (to remove glandular tissue) as well as liposuction, is required for optimal results.

Keep in mind that there are inherent risks involved with GRS. Risks such as concavities, noticeable scars, hematomas, infections etc... Most surgeries however, are performed 'without' any adverse affects. I just wanted to make you aware that there 'are' certain risks you take when having GRS.

Also, do not assume that Tre will have a 'perfect' chest after surgery. Sometimes there are irregularities such as concavities and/or minor lumpiness. You must have 'Realistic Expectations' of GRS. You should be aiming for an improvement, not perfection. GRS is just a fix, not a cure. PS's can only do so much. They are only human like the rest of us. They are not magicians or wizards that can magically zap away Gynecomastia...


GB

[Chodel]

I think the two conflictnig issues here are obviously the mental suffering your son is experiencing Vs the need for him to have surgery at such a young age.

I think having surgery is a massive thing, and i am in my 20s and still concerned about having it (although looks as though I will).  Personally, and of course this is just my opinion 9 years old is far too young to be having this surgery.  However, growing up can be some of the hardest years to suffer from gyne purely because of how children treat other children who appear different.  One of my biggest concerns with operations of this nature for young children is that... shouldn't they be allowed time to grow and mature into their bodies before action is taken?  As I have said this is easier said than done given the suffering a child can experience with a condition like gyne. 

Sorry, i've not read your post in detail because I am in a hurry, but have you asked your son the following..."if you could click your fingers and make the gyne go away would you"?  Is it you that is pushing for the surgery or is your son demanding a solution?

My heart goes out to both of you, because I can see what an awful position you and he are both in.  Just don't make any hurried decisions.  I'm no expert but based on what I have read most operations of this nature are conducted from 18+ so I would assume there is little known about the consequences for younger children, or possible problems with it returning.  Also if his estro levels are inbalanced then this needs to be addressed first, right?

Good luck to you both, and I hope you come to the right decision.