Hey doc, I developed puffy nipples some time between the age of 10 or 12 and have had them ever since. I used to be much chubbier until I was about 17 or 18, when I became rather athletic/fit (but still big, around 230 pounds) in highschool.
I got injured at age 18, had two knee surgeries and ballooned up to 260 pounds. Now, I'm 6'1", I've trimmed down to about 200 pounds and I'm 22 years of age. Here are my pictures:
http://img268.imageshack.us/gal.php?g=imm20090920175149347.jpg
I believe that I do have a mild case of gynecomastia due to the way that my areolas protrude and slightly disfigure the bottom of my chest (which is more visible from the side/top views). Do you agree? Or could that shape be a characteristic of just plain old fat?
From what I've learned so far, what I've assumed has always been "chub" at the bottom of my chest is actually gland. I plan to talk to a couple of GP's as well as a couple of PS's in my city to get their opinions as well.
Also, given the shape of my chest, do you think I'd be a good candidate for gland excision? And if so, would lipo also be necessary? I just don't feel as though I have all that much fat in my chest and the disfigurement didn't become apparent to me until I started losing weight. I only just Googled "puffy nipples" this past Thursday and that's when I exposed myself to all of this information.
Finally, given the brief history of my gynecomastia that I've shared with you, what are the chances of it disappearing by itself at my age and if I do get it removed, what are the chances of it growing back?
Thanks a million, cheque's in the mail! 
Congratulations on the weight loss! Does it not feel much better at the lower weight?
Weight loss does not help with gland. After major weight loss, remaining gland, fat, and skin can be issues.
The male chest can be distorted by both Gynecomastia Male Breast Enlargement. Drooping or Ptosis is a frequent problem after massive weight loss or deflation of massive muscles. 60 pounds is a good amount of weight. Weight loss can leave a great deal of loose skin in many different parts of the body. How much loose skin can vary from person to person. It can take from 6 to 18 months for the skin to tighten after massive weight loss according to the literature on gastric bypass patients.
Posting Standard Pictures to Show Male Chest Drooping after weight loss can help others better understand if the loose skin component is a factor. The bending over views from the side better show the amount of loose skin than oblique photos. The flexing views are to demonstrate just how low the nipples are in relation to the lower part of the pectoral muscles.
Low areola and sagging skin do not give a good contour to the male chest. Surgery to deal with both the residual contours of gynecomastia and loose hanging tissues can be combined. Male Mastopexy Chest Lift for Drooping Chest or Ptosis can consist of many different Surgical Options for Excess Skin of the Male Chest. A Short Scar Skin Reduction Chest Lift hides the scars under the pectoral muscles and around the areola.
For those not happy with their body fat content, continuing with weight loss before surgery is usually a much better approach. Having an operation and then losing further weight is a gamble that the skin will remain tight. Usually skin loosens further with additional weight loss.
No Surgery Body Shaping Garments are a fine temporizing solution while continuing to lose weight.
Gynecomastia surgery does not prevent breast regrowth. Shreds of gland remain behind with any surgical technique that can regrow after surgery if stimulated. Fat put back on the male body will again result in breasts, it is just the pattern of Male Body Fat Distribution.
Hope this helps,
Michael Bermant, MD
Learn More About Male Mastopexy Chest Lift for Sagging Tissues
Please elaborate on "regrowth". Is this commonly seen in patients after the surgery? If so, how long can I expect before the glands redevelop? Or do they only regrow when stimulated? Do patients often return for "revisions" due to regrowth? Like, is this something that people often have to have corrected multiple times? I was under the impression that once it was removed... it doesn't come back. Unless otherwise stimulated like you said...
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.
Here is another example of
Gynecomastia Breast Regrowth on my site. Caution this is a graphic picture of the massive gland regrowth removed on the operating table.
This patient is rather unusual. He was a misdiagnosed genetic female who has lived his entire life as a male. His birth certificate says male as does his driver's license. Yes, a terrible mistake labeling him male made from birth and early on not recognizing his
Congenital Adrenal Hyperplasia. His body has been exposed to high levels of androgens and estrogen since within his mother's womb. This results in an a condition better called
Intersex than the older phrase Hermaphroditism.
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 and stabilizing the problem(s) causing gynecomastia, when possible, is much better. We help patients explore such issues during consultations or preliminary remote discussions.
Hope this helps,
Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction
Topic: Can I get a doctor's opinion please? (Read 4600 times)
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