Typical Timeline for Surgery Option

[fguss01]

Gents,

Is there such a thing as a typical timeframe from adult gynecomastia appearing and it stabilising to the point that surgery can be performed or is this extremely variable depending on individuals?

Many thanks.

[Litlriki]

I would question what you mean by "adult gynecomastia."  The condition occurs commonly during 3 periods in life--newborn (from maternal estrogens across the placenta), adolescent (related to hormonal fluctuation in puberty), and in old age (due to lower testosterone levels in older men).  When the condition occurs at other times, an inciting cause should be determined, since that could include problems such as hormonally active tumors. 

In other words, there is nothing typical about "adult gynecomastia," but it needs to be evaluated before any treatment is instituted, since the treatment of the gynecomastia is primarily cosmetic, while the treatment of the cause could be life-saving.

Rick Silverman

[fguss01]

Sorry Doctor, I wasn't clear - I have activevly growing idiopathic gyne, although I think it was triggered by a 5 day course of Motilium (not too concerend on what causes it though I just want the pain and growth to stop) - been growing for around 2 months and very sore.

I am on Tamoxifen for 3 weeks now but it has not stopped the growth or pain, I am under the care of an endo and all usual feminising tumours and diseases have been ruled out - gyne has been confirmed by ultrasound.

All markers are normal except for E2 which is on the upper limit of normal.

Given that it looks like my Gyne will not go away on it's own I am wondering on the length of the end game - ie how long will it continue to grow? and when could I consider surgery?

I assume that surgery is out of the question on growing gyne - I am 51yrs old.

Many thanks.

[Litlriki]

Thanks for the additional information.  You should have your hormonal levels normalized before pursuing surgical correction, since if the levels remain abnormal, the likelihood of recurrence is greater.  It's possible that you'll see some resolution of the condition with normalization of the hormonal levels, though you might still require surgery.  With patients who develop gynecomastia related to medication, steroid or pro-hormone use, I generally recommend a period of six months after alleviation of the cause to see if resolution occurs.

RS

[fguss01]

Doctor, thanks for the response, one final question from me.

I had assumed that if my hormones remained  at the current levels that the endo would not try and re-engineer them as they are within the "normal" ranges - although E2 is on the upper limit.

In this case I guess that I would just have to wait until the gyne stops growing and then wait a further 6 months?

If I do this and my hormones remain stable at their current levels could the gyne then grow back from a remanent ammount of gland?

Forgive my ignorance but I am an engineer rather than a doc!

[Litlriki]

The sub-areolar remnant that we leave behind to avoid risk of deformity can grow in the future if stimulated.  That's why you want levels to be normal when you have your surgery, and you want any underlying cause of abnormality to be remedied.

RS