Most guys here who have surgery, usually disappear shortly thereafter. I assume, that their surgeries went well and have moved on with their lives... 
'Reoccurring' gynecomastia is very rare...
'Scar tissue' dissipates with time...
'Revision surgery', IMO, is not all that common. Many guys, shortly after surgery are freaked out by swelling and such and are very quick to say that they need a revision. When probably in most cases, it's not necessary at all.
To the resident Docs... How many gynecomastia revisions are done? Just a ball-park figure, percentage wise... thanks!
GB
I perform many
revision gynecomastia operations. Most are for patients who are unhappy with results from other doctors. I have performed revisions on patients who had gynecomastia surgery by plastic surgeons, general surgeons, gynecologists, urologists, ER doctors, family practice doctors, radiologists, and those with no certification at all! That is why it is so important to pick a doctor who has demonstrated good technique with this surgery. I will probably need to expand that section of my website to show many more examples. That is also why I put up a section on picking a surgeon for gynecomastia surgery here on this forum:
http://www.gynecomastia.org/smf/index.php?topic=16474.0However, there have been a significant number of those who had regrowth for problems not stabilized before surgery.
Recurring gynecomastia is not rare when the underlying problem is not addressed first.
I 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.
There were a couple of my patients who initially completed their paperwork stating that they had growing tender breasts. When I then told them they needed an endocrinology evaluation before I would continue considering surgery, the stories changed. Their breasts were not "really" growing, and they were not "really" tender. Each turned out to have underlying endocrinology problems and had recurrence after surgery.
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 for patients I have sculpted. 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 have seen cases of gynecomastia recurrence from other doctors' surgery. One example recent example was a male nurse who brought in pictures before surgery with large breasts, pictures of a flat chest after this other doctor's surgery, and new breasts bigger than what he started with. I set this patient up for a better endocrinology evaluation and we found he had Adrenal Genital Syndrome, a defect in his adrenal glands management of cortisone creating massive levels of testosterone and estrogen since he was in his mother' womb. His birth certificate said male, but his chromosomes, never checked before were XX. He was not a he, but a misdiagnosed female who could have lived a normal life as a woman if his doctors had just taken the time to evaluate his problem and not jump the gun for surgery! I will be adding this sad story to
Plastic Surgery 4U soon.
I prefer to target the gland first with my
Dynamic Technique. This permits me to remove most of the gland and then sculpt the remaining tissue to minimize 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. With my techniques and my
Red Flag Evaluation System before surgery, I have only a few patients over the many years I have been doing surgery that I know have regrown. This puts my recurrence rate at well under 1%. 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. We help patients explore such issues during consultations or preliminary remote discussions.
Hope this helps,
Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery
Topic: User experiences (Read 6865 times)
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