Questions Concerning development/Doctor Apreciation

[blackhawk]

First of all thanks to all the doctors participating in this, the internet can be useless sometimes finding information on specific questions so ya'll can be a godsend for confused individuals like myself.
I'm a 22 year old and stay in good shape but over the past 8 months or so I've noticed changes in my nipples and breast tissue.  My nipples and areola  have become increasingly puffy.  I have also developed a lot of soft tissue and a rounded contour in my chest despite muscle underneath.  It feels as though there is glandular tissue around my nipples, however when pressing down on my nipples it seems to push in a ways, contrary to many glandular descriptions I've read (though I have read many posts in this section and understand glandular tissue may be soft as well as hard). Under my nipples instead seems to be an area of soft lumpy tissue that produces a tingly sensation when pressed on. I never have experienced a real pain in this area as described by many, however too much pressure/stimulation can make them tender.  Most soreness is on the periphery of the breast area and not towards the nipple, and it comes and goes.  It's something I recently discussed with my girlfriend of 4 years who has noticed the changes as well (she is completely supportive and even messages them when they're sore. She's been a blessing). My libido is as high as ever so I'm not sure about hormones.  I was wondering about how long it takes for most gynecomastia cases to develop and about the formation of gland tissue as mine (especially under the nipples) doesn't seem to fit most descriptions on the net.  So far it isn't too noticeable with a shirt on aside from the puffy nipples, but contour is noted without. My main concern is the change in breast tissue, increasing amounts of soft/fatty tissue, and hypersensitivity of the nipples (not always negative).   Thank you so much for all ya'lls time and responses as I'm sure most of ya'll stay very busy....

[Dr. Elliot Jacobs]

Welcome to gyne.org!

Many men try to self-diagnose by feeling their chest.  Problem is that gyne can feel very different -- and yet still be gyne.  Bottom line is that any excessive tissue on a male chest should be considered gyne -- no matter what it feels like.

If you have tingling/soreness and recent onset of the problem, then your first step should be to consult an endocrinologist to check on your hormonal status.  You should also make sure that any medications you might be taking do not have gyne as a side effect.  And Finally, do not take any type of supplements to help build muscle, etc -- sometimes they can affect gyne as well.

Once your chest has stabilized, no longer tingling, etc, and assuming all your hormones are normal, you may consider a consultation with an experienced gyne surgeon to discuss your options.

Good luck!

Dr Jacobs

[blackhawk]

Awesome thank you Dr. Jacobs.  I do not take any medication or supplements.  I started noticing changes in my nipples about 8-10 months ago but kinda wrote it off, its only been in the last two months that I've developed a lot of soft tissue.  I did have shoulder surgery 2 years ago for a broken socket and torn labrum (baseball)  before and after which I was prescribed a good deal of prednisone (what it had to do w/ my surgery/rehab I never was quite sure).  In short I've heard that steroids can be a cause for developent of gynecomastia but wasn't sure if prednisone fell under that catagory or even if it would be a factor since noticeable changes did'nt occur for a good year after. The only other medication was hydrocodone for pain management for about the same time frame as the prednisone.  Also I'm very much against any more surgery (I've had 4 and 3 were very difficult to bounce back from) are there any alternative routes that you would suggest pending proper diagnosis?

[Dr. Elliot Jacobs]

There are many, many different types of steroids.  The ones that cause muscle bulk are called anabolic steroids.  Prednisone, also a steroid, is not in that category -- it does NOT cause gynecomastia.

There are, unfortunately, not many alternate routes.  If all your hormones are normal and there are no other factors to be considered, then you may fall into the category we call idiopathic, which means we just don't know the cause.

Once your condition has stabilized, you may want to get a surgeon's opinion.

Dr Jacobs

[blackhawk]

OK cool that's kinda what I was thinking... assuming that it doesn't progress to the point of prohibiting everyday activity, are there any health risks involved with simply living with the condition?  (Including sterility because I really want to have kids)....

[Dr. Elliot Jacobs]

Gynecomastia is a benign condition -- it does not pre-dispose you to any life threatening problems, including breast cancer (which can affect men as well).  It does, however, have physical implications which affect self-image and self esteem, which themselves can influence one's life. 

Ameliorating the effect on body image by wearing compression garments to give you a better shape can go a long way to "living with gyne."  For many men, this is a viable option.

Dr Jacobs

[blackhawk]

That's good to know... I guess at this point it's not noticeable enough in clothes to require surgery but it will definitely be something I'll keep a close eye on.  Are there any indicators for active growth other than soreness, because I've gotten larger in the past couple months with minimal to no soreness at all.  Aside from appearance and sensitivity in the nipples (mostly a good sensitive), it's been a relatively comfortable and pain free transition...

[Miguel Delgado MD]

The onset of fullness of the chest can occur at any age. It can be due to medication,steroids, suppliments,weight gain, hormone imbalance or unknown cases.  The tenderness makes me believe it is active gladular tissue, normal fat is not tender.  I would rule out the above and get hormone testing if you are concerned.

Surgery is always an option if the appearnce becomes a problem.  Often time the tendernous goes away when the tissue is removed.

Take care
Miguel Delgado,md
www.gynecomastiaspecialist.com

[blackhawk]

Thanks Dr. Delgado... since my last post I have actually been experiencing some pain in my chest starting from the armpits and shooting down diagonally to the nipples, this is the first real discomfort I have had so far.  It only lasted 8-10 secs several times a day for a couple days then hurt consistently for a few days (sort of ironic it first started after the post explaining I've never had pain).  Anyways its subsided now and I only feel it briefly several times a day, normally at night.  How quickly should you notice growth during this stage because its really hard to tell a difference from the existing puffiness ?

[Miguel Delgado MD]

The diagonal pain you describe could be muscular since the muscle runs in that direction. Any kind of glandular growth can be quite slow and difficult to notice from week to week or month to month.  Thank a picture or measure a pinch test to get a baseline.

[blackhawk]

Yea I hear yea, I think the pain towards the arm pit is definitely muscle because its usually a bit more dull, plus I was a pitcher/shortstop through college so I'm familiar with muscle tenderness in that area. It does however get more sharp as it moves under the nipple.  And despite the pain the last week I can't tell any growth as I figured it was a slow process (it's taken nearly 8 months to get where I am now) even though the tissue seems more puffy some days than others.  Anyway here are a some pics I know its probably minor compared to what ya'll normally see but compared to a year ago these are prominent changes, and I just wanted to get a head start before it gets out of hand as I've read the earlier the action the better the results.  Also the pinch photo was taken while flexing...
http://s1134.photobucket.com/albums/m620/01dixie01/   

[Miguel Delgado MD]

The pinch test a prominence of tissue.  This is most likely a combination of fat and gland.  You are an excellent candidate for gland excision and liposuction. You have good quality skin, not hanging, no significant sun damage, and a normal size Ariela which is not over stretched. If you decide to have surgery you should obtain an excellent outcome. You also have good muscle definition.  This would only enhance a good looking chest.

[blackhawk]

Thank you Dr. Delgado it's definitely something I'll keep in mind, although after my shoulder surgery going back under the knife is something I'd like to avoid if possible.  However it may be necessary depending on how much it decides to develop.  I've read that this is most common in older men and pubescent boys, is this something I should worry about at my age?  And is there any link between gyne and infertility,possibly because of hormones?