help: Advice after doctor consultation

[Matty74]

Ive had gynecomastia since I was 13-14 and is the reason why I feel so self conscious. I dont go to gym as I dont like getting changed in the open changing rooms and I hate going out as I feel self conscious and its taken a big hit on my self confidence. I hate being the only guy wearing a jacket in the middle of summer and I have to wear really baggy shirts. It has affected me in a big way and now Im 20. Ive always been a skinny/average build.

So I had an appointment with a doctor and for some reason they only had a female doctor available at the clinic. So I asked her about gynecomastia and she inspected my body. (She probably is the first to see me shirtless since I was like 14) and then told me its probably due to imbalanced hormones and it would go away with time?! I thought pubertal gynecomastia goes away around 18-19 years of age. She also said that other guys have it much worser than me and since mine wasnt severe she could not provide me with any treatment.

Is there anything else I could do?? I assumed pubertal gynecomastia would have gone by now.

thanks

[morpheus11]

that's the typical unsympathetic doctor's response.  just keep in mind, just because she's a doctor doesn't mean she has all the answers.  you'd probably be better off going seeing another doctor about this condition or a surgeon (or both). 

I was in your situation a few years back.  My primary doctor inspected mine and basically said the same thing. He even went so far as to say "what's the big deal, don't get surgery over this".  Just to add a little context to the story, he was a male doctor too, and a fat one at that.  I changed doctors and just recently went to see my doctor about this.  She was totally sympathetic to my cause. I didn't even have to explain it. She said, "it's not vain, so don't feel guilty about getting the surgery."  Point being, she really reassured me and explained in terms of a medical condition I needed to take care of to move on with my life.

Good luck!

[DrBermant]

Ive had gynecomastia since I was 13-14 and is the reason why I feel so self conscious. I dont go to gym as I dont like getting changed in the open changing rooms and I hate going out as I feel self conscious and its taken a big hit on my self confidence. I hate being the only guy wearing a jacket in the middle of summer and I have to wear really baggy shirts. It has affected me in a big way and now Im 20. Ive always been a skinny/average build.

So I had an appointment with a doctor and for some reason they only had a female doctor available at the clinic. So I asked her about gynecomastia and she inspected my body. (She probably is the first to see me shirtless since I was like 14) and then told me its probably due to imbalanced hormones and it would go away with time?! I thought pubertal gynecomastia goes away around 18-19 years of age. She also said that other guys have it much worser than me and since mine wasnt severe she could not provide me with any treatment.

Is there anything else I could do?? I assumed pubertal gynecomastia would have gone by now.

thanks

Sounds like a simply horrible encounter. However, most gynecomastia does go away on its own. What has not resolved by 2 years of the hormone imbalance of puberty typically does not. Gynecomastia with gland still in the active phase, when tissue is still swollen or contours from global fat contribution have the best chance of resolution.

Both the contour problem of gynecomastia and an individual's personal concerns come in many different degrees. I have seen men with a D cup breast that have told me that their breasts do not bother them. Yet, I have seen others with no contour problems that showed in my standard temperature warm exam room who felt that their chests were so deformed that they could no longer enjoy life. (I use a standardized temperature for my exams and photographic documentation to add consistency to contour elements caused by areola muscle spams distorting profiles.) Yes these individuals had a small gland element (all mammals have gland both male and female), but they did not have a female contour to their breasts. There was no deflection or variation of the muscle contour showing. In my opinion, that is not a contour that surgery can improve. Subtract anything and you will get a crater. If the contour does not change with flexing muscles and relaxing the areola muscles with a warm room, then surgery will not improve the contour. The goal of surgery is to get a better contour that can be proven by pictures and documentation such as videos. How can one achieve that when no contour issue shows up? Just like Emperor's New Clothes, an improvement based on words alone without documentation such as pictures, is just not proof of benefit.

Unstable symptomatic gynecomastia may or may not require stabilization. That is an issue I defer to an Endocrinologist. Not all with tender breasts need testing nor treatment. Some hormone blocking medications do carry risks.

Even subtle puffy nipple gynecomastia can be helped by surgery, if that surgeon can demonstrate actual skills with that particular variant of this problem. However, just because a male has large breasts, does not mean they must get rid of them.

In my opinion a doctor encounter that does not educate about such issues is not beneficial. That is one of main problems in dealing with those who do not specialize with gynecomastia. There can be a great deal of emotional concern living with gynecomastia, you are not alone. I have documented not just the contours I can correct with this condition, but also the immense emotional benefit with the videos I have posted.

My suggestion is get another opinion by someone who specializes and has a passion about gynecomastia.

Have you considered posting my Standard Set of Pictures to help others understand your concerns?

Hope this helps,

Michael Bermant, M.D.

[Dr. Elliot Jacobs]

All doctors go to medical school -- but unfortunately, in medical school, there are no courses in tact, diplomacy or how to deal with sensitive/emotional issues.  That is innate in every individual, including physicians -- it cannot be taught.

You, unfortunately, met a physician who was not sympathetic to your problem -- but not all physicians are like that.  Many physicians and pediatricians will see a gyne patient for the first time and just reassure them, pat them on the shoulder and say "wait it out -- it will go away."  And for many guys, it doesn't go away and they end up waiting in vain for something that will not occur.

When I meet such a doctor, I ask them if they had a sister who felt ashamed that she hadn't developed appropriate size breasts by age 20 or so, and whether they might then understand her desire to have a breast augmentation.  Well, the same is true -- in reverse -- for young men who develop enlarged breasts.  Frequently a light bulb goes off in the doctor's head!

For you, with established gyne for a number of years, the answer would probably be surgery.  You just need to find the appropriate sympathetic and understanding doctor who can steer you to the right surgeon in your area.  Keep trying!

Dr Jacobs

[Pooz]

general doctors are fucking idiots when it comes to gynecomastia.
Hell, the military doctors I've seen have been more understanding than the civilian general doctors.