Ok, so I'm not overweight or chubby. 2 years ago I was noticing this lump in my right pec, beneath the nipple. Talked to the doctor, learned about the condition (but I thought it mainly happened to overweight people-true?) and etc. Had surgery through the insurance company for free and hey, it was gone. But then it sorta came back, first with fluid (which the doc drained) and then another lump. She told me she never removed the lump that was waay back there, against the bone, because it would invert my nipple. Later, (6 months) I had surgery again (insurance also covered it again, which was good) and then it was gone. But I could feel a small part of the lump still there, way back. So that was almost a year ago. Now, for the 3rd time, my nipple is puffy and that's really the only place it's noticeable. I don't have a breast. But I don't just mean puffy, I mean like sticking out 1/4 an inch, round, smooth, and a lump behind it. My conclusion is that whatver was still there has moved to fill the gap behind the nipple.
What can I do?? I don't know that the insurance would cover it again. But I don't mean I'm against surgery. My regular doc said it could go away as I get older (I've just turned 16) or when I hit a growth spurt. But I don't know that I can wait. It looks so ugly- one nipple larger and puffy, and the other side normal. I avoid any place like a pool. Also, I feel tingly pain when I press on it - but it's very dull and remote (severed nerves during surgery?). It doesn't get hard even if I put like ice against it or anything, no feeling on the surface.
So..I need help and it seriously makes me feel like shit b/c I can't even wear like an underarmor shirt or anything like that.
Posting a series of
Standard After Gynecomastia Surgery Pictures starting with before the first surgery, then after each subsequent surgery can better help others understand your concerns. Options depend on if the current situation is one of:
- Regrowth
- Residual Scar Gland After Surgery
- Unrealistic Expectations such no external deformity but remaining firm tissues that do not show
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 Revision Gynecomastia and Chest Surgery