Plastic Surgeon for diagnosis?

[chillinaz]

I went for a visit to my general practitioner a couple months ago regarding what looks to me like gynecomastia.
Not just puffy looking but that little bit of extra hang under my chest that I have never seen in my life. He's a great doctor but not so helpful on this one other than a series of blood tests to check my hormone balance. All tests turned out normal. I was told that this sort of thing comes with aging and as long as my blood tests were fine there was nothing to worry about. He couldn't see anything wrong but I would know better as it's my chest.

1. Is my doctor right? Blood tests normal, nothing to worry about? Just getting older? I'm 44 years old and other than high blood pressure, I'm healthy and I've been working out for years. If not aging, why did it happen so damn fast?

2. Is there a specialist other than a Plastic Surgeon that I should pay a visit to before considering surgery?

[George Pope, M.D.]

If you are 44 years old with normal labs and obvious gynecomastia, it's most likely not going away without surgery.  I would recommend you see a board certified plastic surgeon in your area.  Look for one who does a lot of this type of surgery.  You may want to search for a doc on the American Society of Plastic Surgeons website:  plasticsurgery dot org.

Good luck-
Dr. Pope, MD

[Litlriki]

Agree with Dr. Pope as far as addressing this as a surgical concern.  Without seeing photos, it's difficult to comment beyond that, but if it's a matter of aging--less muscle tone, a little more fat--contributing to the more saggy and full appearance of the chest, some focused diet and weight training may help a little.  If that doesn't work to improve it, then surgery would probably be the only option.

Rick Silverman

[chillinaz]

Thanks for the responses. Much appreciated. I included a couple pics as it happened so quickly...within a couple of months, aging alone didn't sound right.

[DrPensler]

A bit more detail would be useful.When did you notice your chest increase in size? Have you lost a lot of weight recently?You need to provide photos to be able to facilitate any meaningful input.

[chillinaz]

I uploaded a couple pictures yesterday. I can see them in my last reply on this thread. If those two aren't enough, I can upload some additional images.

As for more detail. I've never been obese and have always kept myself in excellent shape outside of recovering from injuries. Last year I had a series of surgeries to repair an old injury and wasn't able to work out during that time. Consequently, I gained about 10 pounds. When I went back to the gym, I noticed that when I lifted my arms above my shoulders, the end of my chest was hanging and had some extra girth under my armpits. A jiggling when I walked but only around my nipples. I've never have gained weight in those areas before but I figured it was some extra fat. After dropping the weight and working out for a few months, I was getting back in shape but the problem in my chest wasn't improving or getting worse, just getting more obvious. It feels rubbery, not like fat.

[Litlriki]

You may have some mild gynecomastia, and the accumulation related to aging can be a gradual change.  But occasions of immobility and dietary change could potentially exacerbate an otherwise normal and gradual process, making the change seem to have come on much more suddenly. Your chest isn't bad for your age and body habitus, but I am guessing that you didn't have that little bit of fullness in the lower chest that is notable now.  A decision about how to manage it is completely personal, and if it's making you crazy, surgical correction is a reasonable consideration. 

RS

[chillinaz]

Thank you for the advice. Much appreciated.

[DrPensler]

You have mild to moderate gynecomastia. As far as the comment not to worry about it ,the gynecomastia will not kill you but that is obviously not the point. Your internist's comment is like telling a woman after a mastectomy "don't worry about it ,you are alive". I have found that individuals' appreciation of their body appearance has a direct positive correlation with their BMI and overall health. If you like and take pride in your appearance you tend to take better care of yourself.

As far as who to see a plastic surgeon with expertise in gynecomastia is appropriate.