Hormone tests FINALLY in

[absec9]

Well, I have been having gyno growth for 3 months now, and the docs FINALLY told me that I had a high level of 17 hyrdroxyprogesterone.  I have to get one final test done to check my adrenal gland (had a cortisal level tested today).  Anyway, I am pretty sure it is going to come back positive - in that the test was not a fluke. 

does anyone know what types of steroids can be given to lower levels of 17 hyrdoxyprogesterone?

Also, I know I have asked a similar question, but this is really bothering me. 
I have gynecomastia.  It has grown into a ping pong ball sized lump under my nipple, and there is a layer of tissue all on my chest as well as under my arms almost to my back.  It is breast tissue, not fat (I had an ultrasound done).  Can this breast tissue (not a hard lump like under my nipple) be removed via liposuction?  I know there are aggressive cannulas, but I just don't know if those will work on this thin layer of tissue.  Can it be removed evenly so everything looks normal again? 
I am getting depression medicines today as well.  Everything seems to be crashing down on me because of this - but the end is in sight.  Praise the Lord. 

[DrBermant]

Well, I have been having gyno growth for 3 months now, and the docs FINALLY told me that I had a high level of 17 hyrdroxyprogesterone.  I have to get one final test done to check my adrenal gland (had a cortisal level tested today).  Anyway, I am pretty sure it is going to come back positive - in that the test was not a fluke.  

does anyone know what types of steroids can be given to lower levels of 17 hyrdoxyprogesterone?

Also, I know I have asked a similar question, but this is really bothering me.  
I have gynecomastia.  It has grown into a ping pong ball sized lump under my nipple, and there is a layer of tissue all on my chest as well as under my arms almost to my back.  It is breast tissue, not fat (I had an ultrasound done).  Can this breast tissue (not a hard lump like under my nipple) be removed via liposuction?  I know there are aggressive cannulas, but I just don't know if those will work on this thin layer of tissue.  Can it be removed evenly so everything looks normal again?  
I am getting depression medicines today as well.  Everything seems to be crashing down on me because of this - but the end is in sight.  Praise the Lord.  

There can be many possible reasons for high levels of 17-OH progesterone:

• Inconsistent Testing - That is why some doctors will reorder tests to verify
• Adrenal tumors
• Congenital adrenal hyperplasia (CAH)
• Other forms of Adrenal Hyperplasia
• Imbalanced Hormonal System after Cycle
• Other Factors

Testing may lead to other testing as the Endocrinologist tries to define the problem. Treatment depends on what is uncovered and is best discussed with the Endocrinologist. Once the underlying problem is stabilized, then surgery to correct the residual deformity may be an option.

Hope this helps,

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

[absec9]

Dr. Bermant,
Yes I am having one final test done tomorrow to see how my adrenal gland is functioning.  I believe the doctor wanted all the results at once to be able to make a correct diagnosis. 

Do you have any opinion on my latter question in my first post about the layer of breast tissue all over?

[DrBermant]

Dr. Bermant,
Yes I am having one final test done tomorrow to see how my adrenal gland is functioning.  I believe the doctor wanted all the results at once to be able to make a correct diagnosis. 

Do you have any opinion on my latter question in my first post about the layer of breast tissue all over?

Yes, I have seen extended gland from such conditions and no I do not use liposuction for gland, I have seen too many unhappy patients from other doctors who reportedly told that individual that liposuction alone would be enough. However, I already answered that question for you here in a more extended fashion:

Can this "fibrous" tissue be removed via liposuction of some sort or will I be stuck with this forever?  I have searched online for every gynecomastia information site and I am still not quite sure.  Liposuction is normally used for adipose/fatty tissue, but I don't think this new layer is fat.  Please help me out!! 

Liposuction Is Great for Sculpting Fat

Various types of ultrasonic and power assisted liposuction (UAL and PAL) have been around for quite some time.  Each surgeon uses the tools and techniques he / she prefers.

There are studies claiming that ultrasonic liposuction does not break down gland cells, these were done to justify the safety in female liposuction breast reduction surgery.  Ultrasonic energy cannot be both ways, good for gland breakdown and safe not harming gland unless there is a difference between male and female breast gland tissue which has not been proven to my knowledge.

Tumescent liposuction is a form of anesthesia where fluid is placed in the tissues to be sculpted.  You can see very graphic pictures of the tumecent technique here.

Liposuction such as ultrasonic, VASER, power assisted, and sharp cutting cannula preferentially remove fat over gland.  Gland tends to exist under the nipple areola region.  When fingers of fat extend between fingers of gland, breast reduction can come from removing the fat and leaving gland behind.  On animation such as flexing the pectoral muscles or putting the arms over head, gland does not compress or move like fat.

When gynecomastia is from fat, liposuction works very well for contouring the chest.  I have seen many patients from other doctors who tried to use liposuction alone techniques that left gland behind that the patients just did not like for Revision Gynecomastia Chest Sculpture.

Here is an example of Revision Surgery after Liposuction alone.   

Here is another revision after liposuction alone.

I have seen just too many unhappy patients with puffy nipples remaining after axilla or armpit attempts alone using sharp cutting cannula or other such instruments by other doctors.  Check out this drawing of Puffy Nipple Anatomy after Remote Gland Removal Drawing.

The problem is picking the right method for what actually is that patient's problem.  That is why I prefer my Dynamic Technique that permits what I find during surgery to guide my sculpture.  The incision at the edge of the areola  opens up my entire spectrum of artist's pallet of tools for my sculpture.  A remote incision robs me of many options and just does not looks as nice.  I prefer to avoid this unnecessary additional scar.

I have also seen patients with channel problems between remote access sites and the areola / nipple.  Scars, adhesion, and depressions can look terrible.  Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexing here to see what I mean.

Ultrasonic liposuction uses energy to help emulsify fat.  Power assisted liposuction uses mechanical vibrating devices to rapidly move the cannula back and forth.  Both PAL and Ultrasonic methods have been around for several years.  Many do not prefer what they do to the tissue.  Others like what they offer.  Both still preferentially remove fat over gland.  Both make the work of the surgeon easier.  Some feel ultrasonic liposuction can cause more swelling, bruising, and the increase the need for drains.

For a liposuction cannula to remove gland, it can also remove connective tissue and other structures which can lead to more bruising and scars.  I have seen so many patients who were unhappy from doctors that used "special cannula to remove gland," that I just prefer to go directly to the problem itself.  Primary surgery is usually better than needing a revision.  All male breasts have gland.  With access to the gland directly, I can peel it off the areola muscle, minimize bruising and bleeding with direct control of the tiny blood vessels, and then reconstruct the contour.

For me however, they also both remove the feel of the tissue sculpture.  I like the much better control I get with my cannula selection and personally I do not like either ultrasonic nor power assisted techniques.  None of the cases on my website used either PAL, Ultrasonic, nor sharp cutting cannula techniques. 

As any artist, I take my cannula selection very seriously and have evolved what permits me to achieve my results.  I have considered and evaluated many, many technologies.  The many different types of cannula I use have their own advantages and qualities.  I pick a subset of these cannula that varies for the many different types of gynecomastia male chest sculpture that I see.

Gland removal by any technique can still leave a depression when  a major part of the problem is from gland.  For gland removal, I prefer the greater precision of removal under direct visualization and feel.  This also give me access to many more elements for my artistic palette of my Dynamic Technique to sculpt the remaining tissues.

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat.  How tissues move is important.  The human body is beautiful in animation.  That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views.  Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor.  It is like an artist selecting a paint brush.  The results are what matters, not with what tool they sculpt.

Hope this helps,

Michael Bermant, MD
Learn More aboutGynecomastia and Chest Sculpture

[absec9]

Dr. Bermant,
Yes, I have read this many times already.  I am not asking about fat nor the gland under the nipple.  I am talking about the remaining breast tissue covering the rest of the chest/side torso area.

So I assume your answer is no?

[DrBermant]

Dr. Bermant,
Yes, I have read this many times already.  I am not asking about fat nor the gland under the nipple.  I am talking about the remaining breast tissue covering the rest of the chest/side torso area.

So I assume your answer is no?

Have you checked how extensive the gland component of the breast can extend beyond the central nipple? Take a look at the extent of the gland in this Congenital Adrenal Hyperplasia FTM. Then check Gynecomastia Gland Picture Gallery. Liposuction can manage the fat component, but not the gland. The gland was excised in each of these examples.

Hope this helps,

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

[absec9]

I just glanced through these pictures, but I have seen many similar ones before.  From feeling my chest (which i do about 50 times a day), the gland and dense tissue under my nipple probably spreads about 3 inches all around my nipple.  There is a thing layer of other tissue though.  Right under my armpits and on the side of my chest on the latissimus dorsi muscles.  It's definitely not fat, but it doesn't have the same feel as the breast tissue under the nipple.

[DrBermant]

I just glanced through these pictures, but I have seen many similar ones before.  From feeling my chest (which i do about 50 times a day), the gland and dense tissue under my nipple probably spreads about 3 inches all around my nipple.  There is a thing layer of other tissue though.  Right under my armpits and on the side of my chest on the latissimus dorsi muscles.  It's definitely not fat, but it doesn't have the same feel as the breast tissue under the nipple.

Although gland tends to be firm and fat soft, fat can be firm and gland soft. Clinical Exam of the Male Chest alone is not enough to determine if tissue is fat or gland. A Mammogram of the Male Chest can, but not all patients with gynecomastia need such testing.

Hope this helps,

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

[absec9]

I had an ultrasound on my chest done, and the woman said that it was breast tissue on my chest (not the glandular tissue under the nipple).