Need your help/opinion, Dr. Bermant requested

[bpong]

Recently  I went to Kaiser Permanente and got a referral to plastics by request because of the condition I have which i will describe below.  The referral was returned to my primary care provider because of lack of information provided to plastics with referral.  When i first went to the Dr. he wasnt too convinced of what I had and if it affected me.

I have had tissue/gland? under my areola for the past 4 years, causing it to be enlarged and to protude, something that affects me profoundly.

My Question is, does this "qualify" as gynecomastia?  How should i be describing this to my primary physician so that he can clarify the referral to plastics.  

He already saw it but my nipples were hard and he wasnt able to see the abnormal look to my areolas.  He did however feel the tissue/gland underneath?  To tell you the truth i dont think he really thought anything was wrong or even really cared?

Thank you.

[Paa_Paw]

Our condition is so common that it is statistically normal unless the breast enlargement is considerable.

Sometimes a Psychologist can be an important ally in getting onto the fast track to surgery. Perhaps a referral to a psychologist for depression due to Gynecomastia would be your best help.

Using surgery to treat a Psychological problem may sound odd, but it has worked for some young men.

What have you got to lose?

[DrBermant]

Recently  I went to Kaiser Permanente and got a referral to plastics by request because of the condition I have which i will describe below.  The referral was returned to my primary care provider because of lack of information provided to plastics with referral.  When i first went to the Dr. he wasnt too convinced of what I had and if it affected me.

I have had tissue/gland? under my areola for the past 4 years, causing it to be enlarged and to protude, something that affects me profoundly.

My Question is, does this "qualify" as gynecomastia?  How should i be describing this to my primary physician so that he can clarify the referral to plastics.  

He already saw it but my nipples were hard and he wasnt able to see the abnormal look to my areolas.  He did however feel the tissue/gland underneath?  To tell you the truth i dont think he really thought anything was wrong or even really cared?

Thank you.

I prefer the historic definition of gynecomastia, female breasts in men which can take many forms.  One common term patients use is Puffy Nipples and you can see many different shapes that men do not like about the male chest that does not say male. There is a thin muscle in the areola, that when stimulated, can hide the deforming gland.  That is why I prefer a standard temperature for my exam rooms for evaluating the many gynecomastia patients we see each day.

When patients have a medical problem and current breast growth, I also prefer an endocrinology evalution before considering surgery.  However, patients do not need a referral to be evaluated in my office.  Many start with our Preliminary Remote Discussion before traveling to Richmond.



Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture