recurrence of drug induced gynecomastia after surgery

[max86]

i hav gynecomastia which occured after i took finasteride 3 years back for hair loss. the increase did not regress after stopping the drug( as occurs normally). i m off the drug since then.i am now planning gynecomastia surgery. can i start finasteride again post my surgery?  can it again cause gynecomastia after the gland has been removed?

[Dr. Elliot Jacobs]

First, routine gyne surgery does not remove all breast tissue.  If a surgeon set out to do this, then he would have to remove virtually all of the chest tissue and you would be deformed.  Thus, properly performed gyne surgery will undoubtedly leave some small amount of breast tissue behind.

If, as you say, your gyne started coincidental with Finasteride, then you are probably one of the "lucky" few who develop gyne as a side effect of the drug. 

Should you re-commence treatment with Finasteride after your gyne surgery, then there is a significant chance that your gyne will recur.  And as you have already noted, once it occurs, there is no alternative but surgery to remove the tissue.  Would you want to have the gyne surgery again?

Dr Jacobs

[max86]

thank you..

[Litlriki]

Dr. Jacobs' answer is very clear, but one point of confusion encountered by some patients is the concept of removing all of the "gland," which some surgeons will claim in touting their technique.  Unless the nipple is removed (which would never be done in cosmetic gynecomastia surgery except in rare cases where the condition warrants amputation and free nipple grafting, something I've done once in 20 years), there is always some glandular tissue on the under-side of the areola, and that tissue can re-grow if stimulated--by finisteride or any other medication that might induce gynecomastia.  Beware of surgeons claiming "complete gland removal."

Rick Silverman