Several Questions

[kellerj23]

Hi,
I started to develop gynecomastia only on one side about 5 years ago. It has progressively been getting larger over the years. Although it seems to have stopped growing, in is more pronounced since I've started to work out. I have several questions that I hope someone can help me with.

I take Paxil and Nexium, both of which seem to have a potential side effect of gynecomastia. Is there a chance that mine could shrink/go away if I discontinue use of these drugs for an alternate?

I also recently found out that I have hyperparathyroidism (at least one parathyroid adenoma). Surgery to remove in six weeks. Could this disease be at all related?

Finally, I'm seriously contemplating surgery. Two questions:
1. Is there a risk that gynecomastia will come back after surgical removal?
2. Is the risk greater if I continue on my current prescriptions?

Finally, last night I saw a response to someone elses post form a surgeon in Orange County. I visited his site and like waht I see. I live in Colorado but have family in OC that I could stay with for recovery. Any idea how long I'd need to stay before I could fly home?

[Dr. Elliot Jacobs]

One-sided gyne is not all that uncommon, although I have usually found some gyne on what the patient considered the "normal" side as well.  I always examine both sides and recommend treatment for both if there is indeed gyne on the "normal" side.

Yes, both Paxil and Nexium have gyne listed as a possible side effect.  The question is whether your gyne existed before you went on the drugs and if indeed your gyne got even larger while on the drugs.  If you never had gyne and then developed it on the drugs, then it is possible that they were the cause.  If the gyne pre-existed the drugs, and really didn't change while on the drugs, then more than likely they had no gyne side effect.  If your gyne did increase while on the drugs, then perhaps you do have a gyne side effect from the drugs themselves.  Predictions about what their effect would be if continued after gyne surgery would be predicated on your previous answers. 

One thing is for certain:  once breast tissue is established (via natural processes or as a side effect of drugs, the breast tissue does not disappear on its own (even if the causative drugs are stopped) unless it is surgically removed.

I have not heard about any relationship between hyperparathyroidism and gyne -- but you should check this out with an endocrinologist.

There are some excellent gyne surgeons in southern California.  Recommend you consult with Drs Kapoor and Dr. Cruise.  Both post on this site and have an active interest in the treatment of gynecomastia.

Good luck with your upcoming parathyroid surgery.

Dr Jacobs

[DrBermant]

Hi,
I started to develop gynecomastia only on one side about 5 years ago. It has progressively been getting larger over the years. Although it seems to have stopped growing, in is more pronounced since I've started to work out. I have several questions that I hope someone can help me with.

I take Paxil and Nexium, both of which seem to have a potential side effect of gynecomastia. Is there a chance that mine could shrink/go away if I discontinue use of these drugs for an alternate?

I also recently found out that I have hyperparathyroidism (at least one parathyroid adenoma). Surgery to remove in six weeks. Could this disease be at all related?

Finally, I'm seriously contemplating surgery. Two questions:
1. Is there a risk that gynecomastia will come back after surgical removal?
2. Is the risk greater if I continue on my current prescriptions?

Finally, last night I saw a response to someone elses post form a surgeon in Orange County. I visited his site and like waht I see. I live in Colorado but have family in OC that I could stay with for recovery. Any idea how long I'd need to stay before I could fly home?

There are many possible Drugs that can cause Gynecomastia as well as Medical Problems that can cause Male Breast Enlargement.  Sometimes there is just one, but at others the problem is complex and interrelated. I have seen a patients with Hyperparathyroidism alone causing gynecomastia, it was explained to me by his Endocrinologist that it was the increased Estrogens seen as the factor making the breast grow. Once the Parathyroid issue was corrected, the breast stopped growing. If there are still factors that are making the breasts grow, then there are usually Red Flag Gynecomastia Symptoms that are best stabilized before considering surgery. Many patients continue using medication that are at risk with no breast growth. For others, once one problem fixed, the others are no longer a factor. Yet others, are now sensitive to things that did not cause problems before.

I caution all my patients that gynecomastia surgery does not prevent breast regrowth. There are shreds of gland left behind with any technique that can regrow. Such regrowth is very rare in my practice, but I have seen too many patients with problems not solved before other surgeons' surgery that came to me for major breast growth again. Here is a much more extensive post I put here about breast growing after gynecomastia surgery.

http://www.gynecomastia.org/smf/index.php?topic=19925.msg137027;topicseen#msg137027

Many Colorado Gynecomastia patients travel for surgery. Each doctor has their own systems. How long a patient needs to stay after surgery depends on the problem to be treated, surgeon's techniques, and many other factors. For my patients the stay is for most the day after surgery. Some need to stay longer. That is why that question is best directed to that doctor who you site you liked or other doctor(s) you are exploring what they offer.

Hope this helps,

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