Late Bloomer: Should I Wait?

[Fe2O3]

STATISTICS

Sex:	Male
Ethnicity:	A mix of Western-Eastern European
Age:	23
Height:	196 cm (6'-5")
Weight:	86 kg (190 lb)
Diet:	High in protein, low in crap
Allergies:	None that I know of

Overall, I'm a healthy individual with no prior surgical history.
I've never smoked, don't drink (and never have), and haven't (and won't) taken any sort of steroids.

HISTORY
I've always been a normal-sized (i.e., weight proportional to height) kid. After turning 12, though, I steadily started putting on weight.
Fast forward 9 years, my BMI put me in the class I obesity category. I was 193 cm (6'-4") tall and weighed 122 kg (270 lb) -- that was huge for my thin frame.
I felt absolutely disgusting and finally decided to do something about it. Over the course of 12 months, I lost 42 kg (92 lb) of fat and grew an extra 3 cm (~1").

Three months ago, I decided it was finally time to start lifting weights more seriously.
I've been doing this four times a week and I've seen some excellent results so far, having gained a total of 5.5 kg (12 lb) of muscle.

It should also be noted that I was/am a "late bloomer". My secondary sexual characteristics have been very slow to develop. Facial and chest hair, in particular.
In terms of facial hair, I can only grow ~1/3 of what typical men my age can.
In terms of chest hair, I have lots of vellus hair and only ~15 follicles of androgenic hair per areola.
My abdomen is another story, though.

PRESENT
The only remnants of my horrible past are some stretch marks on my sides and a relatively mild (from what I can tell) case of gynecomastia.
As I recall, I first felt glandular tissue under my areole when I was about 15 years old.
These glandular masses are no longer as sensitive to pressure as they once were.

I thought that after lots of exercise, my body would "correct" itself and that I'd get a "normal" chest.
The only major changes that I've noticed, though, have been an increase of mass in my pectoralis major and minor muscles.
The glandular masses, however, have only decreased in volume by about 15-20%, though perhaps that's just because of "tighter" skin.
Also worth mentioning is that they are of semi-hard consistency when pinched with a thumb and index finger. Definitely not fat.

QUESTIONS

• Taking into account the fact that I'm a "late bloomer", is there any chance that my body will dissolve these hideous things in the next couple of years?
• Since I have a mild case of gynecomastia (at least, I think so), will surgery do more harm than good in the aesthetics department?
• Is it possible that I have some sort of hormonal disorder or some such thing that might be causing me to retain this tissue?
• If surgery is my only option:
  
  • What is the most minimally invasive procedure that can sort this out?
  • Is there anyway to do this sort of procedure under local anesthesia only? I'm deathly scared of going completely under.
  • How "bad" will the scars be, considering that I have pretty fair skin?
  • Can anyone provide me with a ballpark estimate of how much such a procedure would cost in Canada or the US?

PICTURES

Side:
Areole:
Front:
Glandular Tissue: (Marked with a whiteboard marker...)   (Ghetto points?)

IN CLOSING
Sorry if this post is too long or contains too much information, but this has been on my mind for the last couple of months and I want to get it sorted.
I would, therefore, sincerely appreciate any advice you can offer me.

Cheers.

[DrBermant]

Gynecomastia that has not resolved by 2 years, usually does not. All male mammals have gland, it is a question of if that gland deforms the chest as to whether surgery is reasonable. Learning about risks, benefits, and alternative methods of care for subtle Puffy Nipple Gynecomastia are best explored during a consultation or by our Preliminary Remote Discussion. If you are interested in learning more, Jane is my office manager and can explain how we can help.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

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

[Litlriki]

First off, congratulations on your success at weight loss and improving your physique.  Regarding your gynecomastia, as you probably know, the condition is remarkably common during puberty, but 95% of the patients who develop it will experience resolution within a three year period from the time of onset.  Therefore, even in a late bloomer, it's unlikely that you'll see much more change.  That said, only you can decide if the condition bothers you enough to have surgical treatment.  Based on your photos, it looks pretty mild, but I imagine that the nipples are much puffier and more engorged in warm weather.  If that's the case, it's unlikely that you'll see resolution over time, and surgery is probably the only way to improve your situation. 

To answer a few of your questions, the scar will likely be difficult to see afterwards, as it's nicely hidden along the edge of the areola and barely apparent in most patients.  The surgery can be done with local anesthesia and mild sedation.  Liposuction alone will not remove the glandular tissue you're describing, and there aren't many options that are less invasive that would be as effective.  As for cost, that will vary from place to place, and I'm guessing you'll find the cost as low as the mid-$4000s up as high as the $7000s. 

I hope that's helpful.  Please feel free to contact me further if you have any additional questions.

Rick Silverman