surgery

[nc103]

Dear Doctors,
I have had gyne for a little over two years now. It is not due to having too much fat in my chest, it is only the glands under both of my nipples. My main concern is not the fact that I have puffy nipples, but that both of my nipples are in alot of pain anytime they touch anything. I am an athlete, I am not overweight and I am in very good shape, so I'm pretty sure not taking care of body is not what has caused this for me. I am a college student and I just can't afford the surgery but am tired and embarrassed of not being able to trap a soccer ball with my chest because of the shooting pain from my gyne. I know it isn't very likely but I was hoping I could get your opinions if I have a chance to have my surgery covered by my insurance company (united healthcare) or if you have ever had any cases similar to mine covered by insurance companies.

[Dr. Elliot Jacobs]

You may be the rare care in which insurance may help out.  Just be aware that they are not your friend -- they will do everything they can to deny coverage for you because they are a business -- in business to make money for themselves.

If you are over 18 and if you have pain in your nipples, you should document it by going to doctors (internists as well as a plastic surgeon) with this complaint.  The insurance companies will want physician verification of your condition and symptoms -- and may even ask for copies of receipts for pain medications.  They will, of course, want photos of your chest. And you may also want to consult with a psychiatrist so that he could provide you with additional ammunition to prove how it continues to affect your life.

Good luck -- and let us know how this turns out.

Dr Jacobs

[DrBermant]

Dear Doctors,
I have had gyne for a little over two years now. It is not due to having too much fat in my chest, it is only the glands under both of my nipples. My main concern is not the fact that I have puffy nipples, but that both of my nipples are in alot of pain anytime they touch anything. I am an athlete, I am not overweight and I am in very good shape, so I'm pretty sure not taking care of body is not what has caused this for me. I am a college student and I just can't afford the surgery but am tired and embarrassed of not being able to trap a soccer ball with my chest because of the shooting pain from my gyne. I know it isn't very likely but I was hoping I could get your opinions if I have a chance to have my surgery covered by my insurance company (united healthcare) or if you have ever had any cases similar to mine covered by insurance companies.

Pain is one of many Symptoms of Gynecomastia that can be a result of stimulation to grow gland. Surgery will not stop the body from such stimulation and remaining gland will be still subject to the same hormonal environment.  Breasts that are growing or are painful before surgery will continue to grow or be painful after surgery. 

That is why I prefer to target gland first with my Dynamic Technique instead of leaving gland behind to "support" the areola.  However, shreds of gland remain behind with any technique. 

Getting the problem stabilized first helps minimize regrowth after surgery. It is very rare for patients I have operated on to have recurrence, I have seen too many patients from other doctors with regrowth after surgery that did not address the underlying problem.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Dr. Elliot Jacobs]

Agree with Dr B.  You should also get checked out with an endocrinologist.  If your hormones are out of line, then surgery should be deferred until the hormones are stabilized. You would then have an even more compelling case for insurance coverage -- but don't be surprised if they deny you. If your hormones are normal, you have lost nothing in the process. It's not the doctors who are practicing medicine these days -- it's the guy/gal in the insurance company offices -- reading from a script on what they will allow for coverage.

Good luck.

Dr Jacobs