Question for Dr. Jacobs

[Again]

Hello, I am a 30 year old male that has battled drug and alcohol addiction since I was 15.  2.5 years ago I ran into a miracle combination of drugs (working with a doctor, all doctor prescribed drugs) that allowed me to live a normal life without constant extreme yearning for drugs and alcohol.  The drug combination was Subutex (buprenorphine), valium, and depakote.  I am currently taking 12mg of subutex, 20mg of valium, and 250mg of depakote daily.  The subutex I take in the day time, the rest I take right before bed to sleep.  I also alternate a half dose of benadryl (12.5mg) and half dose of doxylamine succinate (12.5mg) every night (one night I take the benadryl the next night I take the unisom and repeat).

Before I started these doctor prescribed drugs, I had never had problems with gynecomastia or weight.  Soon after I started them, I started gaining weight and the gyno showed up.  It keeps getting worse. 

I am in a bad situation now as I cannot go to the pool or beach anymore with my family on vacations because I cannot take off my shirt.  I am extremely embarrassed to take my shirt off in front of my wife anymore.  Its just horrible, sometimes I feel like killing myself.

I am in a situation where I am trying to taper off the drugs but it is an extremely slow process, as my body is very prone to being addicted to drugs. 

My question is this......if I have surgery to correct the gyno, will it come back because I am still taking the drugs that cause it?  Also, if I were to taper off the drugs will the gyno go away on its own?  I have been on these drugs for 2.5 years.  It is likely to take another year to taper off of everything completely.  What do you recommend in my case?  Thank you very much for your help.

 

[Dr. Elliot Jacobs]

Thanks for your message.

I can only speak in generalities because I am not your treating physician and anything I state should not be construed as medical advice for you.

I am a surgeon and do not use these drugs for anything that I do.  Your best reference would be the doctor who prescribed them -- he should know everything about those drugs, including any side effects which might have resulted in weight gain and gynecomastia.  Remember, any weight gain on a male is often reflected on the chest -- so weight loss itself might help your chest. 

In general, if any drug has gyne as a side effect, it would behoove you to be off the drug(s)  before having gyne surgery.  Otherwise, you would have at least a theoretical possibility of re-growth of the gyne after the operation.  Losing weight through diet and exercise would also be helpful.

Ideally for surgery, it would be best if you were stable, off all meds and at your best weight possible.

Best of luck!!

Elliot Jacobs, MD, FACS

[Dr. Elliot Jacobs]

Thanks for your comment.  As a fellow gyne sufferer, I really do feel the pain of everyone who visits this site.  And I try to be helpful whenever I can.

Elliot Jacobs, MD, FACS

[MSJ108]

Ive been reading your post and so forth and all your post are filled with information and actually give an answer whereas other use it for a chance for advertising. I just wanted to say thanks for your time and knowledge that you share with us

Amen to that. Dr. Jacobs is the man!

[Again]

Sorry it took me so long to get back.  Thank you very much for taking the time to answer my question.  Is it possible the gyne will go away on its own after I taper off of the drugs that caused it?

[Dr. Elliot Jacobs]

No way to know or predict -- I guess you will know after the fact.  If part of the chest enlargement was weight gain, then it may improve if you lose weight.  Breast tissue, once established and mature, often does not disappear even though the original process that produced it may be gone.

Elliot Jacobs, MD, FACS

[Again]

Thanks again.  In actuality, I made it sound like the weight gain and the gyne happened at the same time but the gyne actually started first.  I was normal size (always a bit skinny), the gyne showed up a month or so after starting the meds, then maybe a month later I started gaining weight.  So I really do believe that in my situation the gyne is "real" gyne that isn't going to go away when I lose weight.  I haven't gained that much weight but still more than I ever have in my life.  I was 6-2 190 pounds before the meds.  I am now 225 pounds.  The most I ever weighed before taking these meds was 195 pounds.  It is definately real gyne.  The nipples puff up but when I get cold it looks normal.  Needless to say that on the beach I dont get cold so my chest really pokes out big time.

Again thanks for your help Dr. Jacobs.  I may one day be paying you a visit to correct my gyne.

[Grandpa Bambu]

Ive been reading your post and so forth and all your post are filled with information and actually give an answer whereas other use it for a chance for advertising.

No diss'n intended towards Dr. Jacobs here... but what do you call this....


Dr. Jacobs 
Diplomate, American Board of Plastic Surgery
Practice sub-specialty in Gynecomastia Surgery
815 Park Avenue
New York, New York 10021
Telephone:  (212) 570-6080
Email:  info@drelliotjacobs.com
Website:  www.gynecomastiasurgery.com

Sure looks like a 'Calling Card' to me dude....


'Other' just does it in a more aggressive manner...


GB

[MSJ108]

As long as he keeps answering questions and keeping this board strong...I am all for it!

[Grandpa Bambu]

Yeah, I hear ya there dude...

Yup, 'Doc J' is Da Man!

GB