When appropriate for teenager to have surgery

[machasen]

My son is 16 1/2 . He has gynecomastia for over 3 years ( pretty much with major Onset of puberty ). He's seen an endocrinologist . Took https://richmond.craigslist.org/fuo/5509978370.html for a bit, it helped but then it grew back . First not as big but now bigger . Took seconds round tamoxifen but did not work . Question is is it too early to have surgery with risk of it growing back if he does ? As puberty may not be over . What are ur thoughts ? Thanks  round of tamoxifen but did not work . 

[Dr. Elliot Jacobs]

If your son has had stable gyne for over 3 years, then it most likely will not disappear spontaneously.

I have operated on hundreds of teens with two years or more stable gyne, from age 12 - 18, and to date none of them has had a recurrence.  If one does hormone testing on these teens, their hormones are normal for their age.  

Many docs urge teens to wait it out til the magical age of 18, when miraculously their gyne will disappear overnight.  Baloney!  These teens will have spent their precious teen years waiting in vain for something that just won't happen.

Dr Jacobs

[DrPensler]

If your son has persistent gynecomastia for over 3 years it is extremely unlikely that there will be any significant regression. Tamoxifen is not effective in your sons situation.There are risks associated with ingestion of any drug under all circumstances  and to take a medication when it has no efficacy particularly in a developing  adolescent is absolutely contraindicated. The reason to see an endocrinologist as a child is to rule out several genetic causes,pituitary tumors,adrenal tumors and testicular tumors in order to perform the surgery at an earlier age to minimize the associated issues which universally develop. Deferring surgery until 18 typically is recommended by individuals who do not have surgical privileges to operate on younger individuals.

[machasen]

Thank you both for your responses. So it sounds like it might be appropriate to pursue the surgery . He is a bit self conscious about it and has been handling it well , but I think it has been bothering him lately . 

[machasen]

Also, what is the likelihood of insurance covering it . More unlikely than likely I assume 😬

[Dr. Elliot Jacobs]

Unfortunately, insurance coverage is highly unlikely.

Dr Jacobs

[Litlriki]

Agree with Drs. Jacobs and Pensler--Gynecomastia that hasn't resolved within 3 years of onset is very unlikely to resolve, and addressing it as a teen will alleviate much of the struggle that many young men experience from the condition.  Insurance is not likely to cover it. 
Good luck!