Hello All,
This is my first post to the board, so please forgive me if these questions have been asked before....
I'm 5'10" (178 cm), weigh about 150 lbs (68 kg) and have had gyne probably since about age 16 or 17. There's really nothing I've been able to do to get rid of it -- I guess I somewhat reduced the appearance by getting down to about 135 lbs (61 kg) -- but that was a pretty unhealthy weight for my 5'10" height.
Anyway, I've since leveled off at about 150 lbs, and I'm pretty active by most measures ... I run about 20 to 30 miles (about 40K) a week. But my gyno is still pretty embarrassing, and it seems like whenever I do gain any weight -- even just one night's worth of eating quite a bit -- I can feel a noticeable increase in my chest size.
I guess my questions go out to any *post-surgery* guy that was in a situation similar to mine (slim guy, but always gained weight in the chest):
1. After surgery (I'm talking months, or even years), do you experience any recurrence of gyne? I wonder about this, because (as I mentioned above) whenever I indulge even slightly, I seem to instantly gain weight again in my chest.
2. Overall, are you happy with your decision to have surgery, or do you regret it?
Thanks in advance for any help you can offer.
-RM
Gynecomastia Surgery Does Not Prevent RegrowthI caution each of my patients that surgery does not typically stop male breast growth. If there is a problem with growing breasts,
recurrence can happen. Any of
these medical problems and or
these medications can cause gynecomastia. So, if you want to get worried about regrowth, you could get yourself evaluated for each of these conditions to see if they could be a factor.
Surgery also does not prevent weight gain in the chest. Men tend to put weight on the belly and chest regions. I educate each of my patients that this surgery will not prevent further breast growth. It is like changing/fixing a tire with a nail. Fixing/changing the tire will not prevent you from getting a new nail in that tire.
I take care of many patients with gynecomastia, as many as 8 in one day alone. With all the gynecomastia surgery I have done, it is
very rare to have regrowth. One patient (who had surgery on only side by another doctor) came to me with pro hormone induced gynecomastia that only came back on the side that had no surgery. His growth was massive on the one side and none on the other. His surgery by that other doctor had left a massive crater - the skin was adherent against the chest wall with normal fat surrounding the ugly deformity. One side looked like the deformity seen
here. The other side was almost a B cup breast so tender that I could barely examine it. As with each patient who presented to me with current breast growth, he was referred for an endocrinology evaluation and stabilization before considering surgery. I do not know if such radical surgery was a factor or not. Even if it did, removing all fat under the skin just gives an unnatural look.
I prefer to target the gland first with my
Dynamic Technique. This permits me to remove most of the gland and then sculpt the remainng tissue to minimze contour problems. Any surgery technique, even radical breast mastectomy for male breast cancer can leave gland behind. The problem is that there are fine fingers of gland that dissect between fingers of fat and can extend quite far into the chest.
You can see what I mean by
fingers of gland here.By concentrating on the gland first I am able to minimize the chance of breast regrowth. It is very rare for my patients to have recurrence. However, gynecomastia surgery does not stop breast regrowth. For patients having breast growth, I have advised for many years that they should get their problem under control before surgery. There are exceptions, such as young men with massive breasts that have not stopped growing. That is why each case needs to be individually evaluated.
Prevention of gynecomastia, when possible, is much better.
Secondary Surgery is often an option for those who had prior surgery. Such issues are better discussed during a consultation with your surgeon or someone who can advise you about your options. We help patients explore such issues during consultations or preliminary remote discussions.
Hope this helps,
Michael Bermant, MD
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