Post Op: How to prevent recurrence of Gynecomastia

[Darth Menace]

hey guys, sorry if this is posted elsewhere, but i couldnt find it.  I just got the surgery, which equals alot of pain/$.  I am wanting to know what to do to prevent it from coming back.  I know eating/drinking/certain drugs make it come back as well as other stuff.  is there a thread already exhisting on this as I would like to know how to move forward after the surgery

[DrBermant]

hey guys, sorry if this is posted elsewhere, but i couldnt find it.  I just got the surgery, which equals alot of pain/$.  I am wanting to know what to do to prevent it from coming back.  I know eating/drinking/certain drugs make it come back as well as other stuff.  is there a thread already exhisting on this as I would like to know how to move forward after the surgery

Recurrence of gynecomastia is quite rare for men with stable problems. Surgery does not prevent  new growth after surgery. It is the individual who rushes into surgery without first addressing the underlying problem that runs the risk of recurrence. I unfortunately have seen many such patients done elsewhere. In addition, if a new cause starts, then the breast tissue can grow back.

I caution each of my patients that surgery does not typically stop male breast growth.  If there is a problem with growing breasts, recurrence can happen.  Any of these medical problems and or these medications can cause gynecomastia. So, if you want to get worried about regrowth, you could get yourself evaluated for each of these conditions to see if they could be a factor. 

If you are using something that can stimulate breast regrowth, shreds of gland remain behind with any surgical technique.  It is just not practical to remove all elements of gland.  The problem is that there are fine fingers of gland that dissect between fingers of fat and can extend quite far into the chest. Take a look at the Anatomy of Gynecomastia to see what I mean.  Even with a radical mastectomy (a disfiguring technique used for some male breast cancer problems), some gland can remain.  Surgery also does not prevent weight gain in the chest.  Men tend to put weight on the belly and chest regions.  I educate each of my patients that this surgery will not prevent further breast growth.  It is like changing/fixing a tire with a nail.  Fixing/changing the tire will not prevent you from getting a new nail in that tire.

Regrowth of gland from stimulation can occur where shreds of gland remain behind. This can be behind the areola, along the deeper edges or margins of a zone of excision. 

I take care of many patients with gynecomastia, as many as 8 in one day alone.  With all the gynecomastia surgery I have done, it is very rare to have regrowth for patients I have sculpted.  One patient (who had surgery on only side by another doctor) came to me with pro hormone induced gynecomastia that only came back on the side that had no surgery.  His growth was massive on the one side and none on the other.  His surgery by that other doctor had left a massive crater - the skin was adherent against the chest wall with normal fat surrounding the ugly deformity.  One side looked like the deformity seen here.  The other side was almost a B cup breast so tender that I could barely examine it.  As with each patient who presented to me with current breast growth, he was referred for an endocrinology evaluation and stabilization before considering surgery.  I do not know if such radical surgery was a factor or not.   Even if it did, removing all fat under the skin just gives an unnatural look.

I prefer to target the gland first with my Dynamic Technique. This permits me to remove most of the gland and then sculpt the remaining tissue to minimize contour problems.

By concentrating on the gland first I am able to minimize the chance of breast regrowth.  It is very rare for my patients to have recurrence.  With my techniques and my Red Flag Evaluation System before surgery, I have only a few patients over the many years I have been doing surgery that I know have regrown.  However, gynecomastia surgery does not stop breast regrowth.  For patients having breast growth, I have advised for many years that they should get their problem under control before surgery.  There are exceptions, such as young men with massive breasts that have not stopped growing.  That is why each case needs to be individually evaluated. 

Prevention of gynecomastia, when possible, is much better.

Hope this helps,

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

[Darth Menace]

thank you very much for the long and insightful answer.  I understand that Gynecomastia surgery isn't a cure all for gynecomastia.  From speaking to my surgeon, my Gynecomastia was more adolescant gynecomastia and stayed with me until I got rid of it.  Huge glands were removed and over 1 cup of fat per boob.  What I was more meaning is what foods, drugs, and drink cause gynecomastia to be produced.   For instance I heard drinking Soy Milk can produce male breasts as well as smoking pot.  I do not do any illegal drugs so I have no worry there, but that is just one of many examples.  I was more meaning is there is a list of what products to avoid to help prevent gynecomastia?  I've seen people mention products here and there, but I was wondering if there is a proper list of some sort

[DrBermant]

thank you very much for the long and insightful answer.  I understand that Gynecomastia surgery isn't a cure all for gynecomastia.  From speaking to my surgeon, my Gynecomastia was more adolescant gynecomastia and stayed with me until I got rid of it.  Huge glands were removed and over 1 cup of fat per boob.  What I was more meaning is what foods, drugs, and drink cause gynecomastia to be produced.   For instance I heard drinking Soy Milk can produce male breasts as well as smoking pot.  I do not do any illegal drugs so I have no worry there, but that is just one of many examples.  I was more meaning is there is a list of what products to avoid to help prevent gynecomastia?  I've seen people mention products here and there, but I was wondering if there is a proper list of some sort

The resources I provided in my prior post:

Any of these medical problems and or these medications can cause gynecomastia.

are the most complete collection of drugs and causes of gynecomastia I know of. They are the product of years of evolving such information for the public. Getting more detailed than that is not really practical.

Hope this helps,

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

[Darth Menace]

thanks for your help.  I must have missed your list earlier on

thanks

[DrBermant]

thanks for your help.  I must have missed your list earlier on

thanks

You are quite welcome!

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

[Darth Menace]

a couple more questions.  Does smoking cause re-occurrance?  Soy milk?  Alcoholic beverages?  I am not a person that has to take many perscriptions so perhaps that drug list won't hamper me at the moment, but what about the above three items?

thanks again

[DrBermant]

a couple more questions.  Does smoking cause re-occurrance?  Soy milk?  Alcoholic beverages?  I am not a person that has to take many perscriptions so perhaps that drug list won't hamper me at the moment, but what about the above three items?

thanks again

Alcohol in major abuse situations can destroy the liver. The liver's failure to manage the breakdown of testosterone in the body can result in gynecomastia. It can be quite difficult to track down the effect of any particular item, any such single item is hard to isolate from the many others of daily experience. Take pot for instance. There are no decent studies documenting the male breast growth from this substance. Yet many say it is related. I have had a few patients who complained of breast tenderness when using large quantities of pot that then went away when they stopped. The symptoms came back when they restarted smoking and went away again when stopping. For those individuals, there probably was a connection. Yet because of the illegal nature of that item, finding real research just is too difficult.

Hope this helps,

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