Ok, So I had my surgery in july last year.
I have been taking Elavil since then and now I think my gyne is coming back.
The problem is in the right nipple. At first I tought it was just scar tissue, but it's been growing since then. My left nipple had a big indent after surgery but after working in the gym I think is gone, but just a few days ago I noticed a bump I had never felt.
So I'm scared. I decided to just quit elavil this week. Do you think it could shrink? Although I know is practically impossible.
I have big problems with depression so I just don't know how will it result.
So there are my pictures, I need opinions on what to do.
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.
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.
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. Any surgery technique, even radical breast mastectomy for male breast cancer can leave gland behind. The problem is that there are fine fingers of gland that dissect between fingers of fat and can extend quite far into the chest.
You can see what I mean by
fingers of gland here.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.
Hope this helps,
Michael Bermant, MD
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