Tamoxifen & Gland returning, scar tissue

[cowboy100]

I am so frustrated I have had surgery 3 years ago, revision 2 years ago, a kenalong shot and nipple reduction surgery. After my first surgery it took about a year but my chest started to get pointy, not really puffy. Then revision for scar tissue, 6 months later pointy, then a kenalog which I think got the left side a bit but not great. Then because they were mainly just pointy had nipple reduction.

Basically I can feel some hard clumps under my nipples in various areas, they are starting to get more puffy and only look ok when really relaxed like sleeping or sitting for a while at best. I am wondering if gland is maybe returning how was can it be returning because I feel like they are worse everyday but I am also working out. Also I want to maybe take tamoxifen, will this stop it and maybe reduce it and what will happen if I take this and its actually just scar tissue not gland. This just makes no sence because for like a year after my first surgery my chest was soo flat, and after revision fairly flat again...not its like if I move much or a cold wind hits it its so pointy and the area around the nipple sticks out too...What do I do here...Kenalog, tamoxifen, both...my PS seems baffled 

[cowboy100]

also can gyno gland form anywhere else other then directly under the nipple because I have a huge chuck of something below my left nipple, its not under the nipple but just below it

[Litlriki]

Sorry to hear about your saga.  It's difficult for us to comment without knowing the original etiology of your gynecomastia, and of course, photos are always helpful as well.  The more information you provide, the more likely someone might have some thoughts to share with you that could be helpful.

Rick Silverman

[cowboy100]

I'm really looking to get a fast answers here because I feel like I need to ask fast. Mainly can someone just say what will happen if I take tamoxifen and my gland is actually not returning, how will it effect me. It has been over 2 years since any kinda serious surgery, and my chest seems to slowly be getting worse ...is it even a possibility that ifs from scar tissue because both sides are slowing starting to point out a bit...and will temoxifen actually decrease this if it is gland returning

[Dr. Cruise]

I have heard similar stories.  It is impossible to tell you exactly what's happening in your situation, but after performing several hundred gynecomastia procedures, I've seen on occasion excessive healing tissue that ended up replacing the removed breast tissue.  This occurrence has led to me slightly change how I perform gynecomastia correction over the past few years. To truly limit scar tissue formation, I routinely suture the skin down to the underlying pec major muscle.  This effectively binds the skin to the muscle to the muscle so that it heals quicker and limits the amount of scar tissue that forms between the two. Without the suture, the pocket that is created may potentially fill with scar tissue... this may be what happened in your case.  Another reason I do this is to prevent seroma formation.  These sutures are demonstrated in this animation. 

[cowboy100]

I don't full understand what you are saying in yours post dr. also if my problem is similar to what you are saying will kenalog fix this. I just feel like my nipples are so sensitive from being cut into so much that my muscle contracts all the time and pushes the scar tissue out. I can easily feel the scar tissue or chunk of whatever under my left nipple and my family doctor actually suggested botoz since Im fairly happy with how they look relaxed. 

[Litlriki]

I have to admit, your description of your history is confusing and not especially helpful.  What caused your gynecomastia originally?  Was it just from puberty, or did you use steroids or pro-hormone supplements?  If it was steroid-related, have you used them again since surgery?  When you talk about the nipples being pointy, is it just that when you look down, in an erect state, the nipples are more projecting? and when they're relaxed, they seem flatter?  This is normal. A lump that is remote from the nipple could be some gland that was left behind, or it could be scar tissue.  Photos would help.  You're not likely to get an answer that is satisfactory without a clearer and more detailed history.  In fact, your surgeon, who knows your history, is baffled, and you're only giving us a few details, so how can we comment intelligently?

That said, there is no rush to do anything--this is not a life-threatening condition, and in many cases, just giving the tissues time allows for resolution of some problems.  If your hormonal levels are normal, use of a drug like tamoxifen will do little to help your chest (and could worsen it!) and may still have other side effects.  So before going in that direction, you should have an  endocrine assessment.

Rick Silverman

[cowboy100]

I am having an endocrine assessment very soon I have been approve by my doc to go to a lab for one. My nipples are overly pointy when cold/not relaxed. I apparently it MAY be because my nipple my not have reattached to fat underneath after surgery. Anyways I think I described my history as best I can, but I will say it was hormonal, not steroid or drugs, never taken that. I had it right after puberty at about 13-14 and had surgery when I was 19 or 20, 3 years ago, revision a year later, kenalog on one side, then nipple reduction and I had kenalog on both side 3 days ago so we will see how that goes. after each surgery it looked great for a few months they started to get pointy and puffy when no relaxed. I may just need botox to keep it relaxed because I don't think any doctor on here has given me a solution yet. and my family doc thinks it is also so sensitive because it has been cut into so many time, recommend I stop seeing a PS and if its a real problem just get botox cause its not that bad but I still can not wear a t shirt with out showing some nice points.

[Litlriki]

It sounds like you just have prominent nipples, but I'm not sure, since you said you had a nipple reduction.  Some photos could be helpful.

RS