Puffy Left nipple and Hyperprolactinemia ??? any advice

[puffybegone]

Hey everyone, i have just been recently diagnosed with a Hyperprolactinemia with through the roof prolacitn levels, i havent been feeling very well since i was 17 im now 25 male and really wanting to get some sort of happiness back.

The Doctor told me that my condition can cause male breasts and that hopefully it will go away in time with my meds (cabergoline/Donstinex 2x weekly) ive been on them now for nearly 7 months and i know they are working well on dropping my prolactin levels, as i have facial and body hair growing that ive never had in my life ( Doctor thinks ive had this condition since my early teens so never hit puberty) my libido has increased and nop longer have erictile probs, and ive lost a ton of weight which i couldnt lose before even when i worked out twice as much as i do now.

But the more wiehgt i lose the more apparent this puffy nipple thing is, it looks worse when im warm or relaxed and goes with coldness or if i pour water on them..... when i feel them they feel just like water balloons with nothing in behind them, i do feel some gland a away back but nohwere near the actual nipple area which points out like a crayon.

Is there anything i can do about this ? or is surgery the only way ? anyone ever had this with prolactinoma and its sorted itself out ?


thanks
 

[DrBermant]

Hey everyone, i have just been recently diagnosed with a Hyperprolactinemia with through the roof prolacitn levels, i havent been feeling very well since i was 17 im now 25 male and really wanting to get some sort of happiness back.

The Doctor told me that my condition can cause male breasts and that hopefully it will go away in time with my meds (cabergoline/Donstinex 2x weekly) ive been on them now for nearly 7 months and i know they are working well on dropping my prolactin levels, as i have facial and body hair growing that ive never had in my life ( Doctor thinks ive had this condition since my early teens so never hit puberty) my libido has increased and nop longer have erictile probs, and ive lost a ton of weight which i couldnt lose before even when i worked out twice as much as i do now.

But the more wiehgt i lose the more apparent this puffy nipple thing is, it looks worse when im warm or relaxed and goes with coldness or if i pour water on them..... when i feel them they feel just like water balloons with nothing in behind them, i do feel some gland a away back but nohwere near the actual nipple area which points out like a crayon.

Is there anything i can do about this ? or is surgery the only way ? anyone ever had this with prolactinoma and its sorted itself out ?


thanks
 

Dostinex (Cabergoline) is a medication that can be used to treat prolactinomas (tumors of the pituitary gland).  When effective, glandular growth is sometimes stabilized, and sometimes regresses.  A Prolactinoma tumor makes too much Prolactin a hormone that causes breast growth to make milk for pregnancy.  Prolactinoma in men can be large enough to press on the optic nerves restricting vision.  It is one of the causes of gynecomastia. For both men and women, breast gland tissue under such stimulation frequently results in tenderness and sensitivity and in men common Symptoms of Gynecomastia and Male Breast Growth.

Gynecomastia surgery is better deferred until such problems are stabilized and wait to see how much the breasts regress on their own.

Fingers of gland disperse through fingers of fat in the normal Anatomy of Gynecomastia. No surgical technique removes all the gland, even radical mastectomy in men (a deforming surgery). I prefer to target the gland elements first with my Dynamic Technique.  Less gland means less target organ for future hormonal stimulation.  That way, in combination to stabilizing problems first, my patients have a very low recurrence rate and revision rate for surgery (less than 1%).

My patients awaiting stabilization for such issues as an endocrinology problem as a prolactinoma have expressed how helpful Compression Body Shaping Garments have been to temporize a natural chest contour.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[puffybegone]

thanks for youre reply Dr Barmant, what i was wondering if it is caused by Low testorsterone once my levels are corrected with cabergoline is there chance they may go away themselves or once they are there the only option is surgery ? also if surgery is the only option if it is a minor case coudl it be lipo'd out instead of a cut ? to avoid scarring?

I stay in Scotland and im worried about selecting a good surgeon for the procedure as ive read in a few posts you have mentioned there are good ones and some bad ones about.

thanks

[DrBermant]

thanks for youre reply Dr Bermant, what i was wondering if it is caused by Low testorsterone once my levels are corrected with cabergoline is there chance they may go away themselves or once they are there the only option is surgery ? also if surgery is the only option if it is a minor case coudl it be lipo'd out instead of a cut ? to avoid scarring?

I stay in Scotland and im worried about selecting a good surgeon for the procedure as ive read in a few posts you have mentioned there are good ones and some bad ones about.

thanks

How much shrinkage depends on many factors. Female breasts enlarge during stimulation for milk production. Once that stimulation is removed many women find that their breasts shrink to a degree. They may shrink back to what they were before the pregnancy, but they also may stay larger than before but smaller than under stimulation.

The same goes for gynecomastia, actually breast tissue is breast tissue for all mammals. Remove the stimulation whether from puberty or pituitary, and some shrinkage happens. For many young men, the small enlargement during puberty does go away on its own. For others some remains behind. The prolactinoma patient is under the same umbrella, but many do not get diagnosed until major breast growth takes place. I have seen a very early diagnosed prolactinoma who did get enough relief that they did not feel they needed surgery. But that was a small gland growth and there was still a remnant, just small enough that the contour was not a major factor.

The moral of the story is: waiting until a problem stabilizes better defines what if anything needs to be done.

Sorry, I have seen just too many unhappy patients complaining about failures by doctors claiming that liposuction alone could manage their gynecomastia. Here are but a few:

• Secondary Gynecomastia Surgery for Puffy Nipples after Liposuction Alone
• Revision Puffy Nipples after Liposuction Alone
• Redo Surgery for Remaining Gynecomastia after Liposuction Alone

Here is a post where I go into greater detail about that subject:

http://www.gynecomastia.org/smf/index.php?topic=18829.msg129677;topicseen#msg129677

You need to evaluate before and after results that look good from many different angles and on animation.

The choice of surgeons can be critical for male chest contouring. I see many Gynecomastia patients from the United Kingdom and around the world who prefer my techniques.  Most start with our Preliminary Remote Discussion to minimize travel to Virginia.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Ezpeaz]

I am also on cabergoline.  I had surgery to remove my prolactinoma which had prolactin levels above 577.  It settled to about 60 after surgery for a year.  I am young so I had genotropin and testosterone injections.  Now I am only on cabergoline hoping that it will bring my prolactin level into the normal range.  I hope that once the prolactin goes back to normal, that my testosterone and hgh go up on their own.  I have the same puffy problem.  I seriously hate it.  I'm now 6' 1" tall and 174lbs.  I have these puffy nipples and I want to know if that will go away on cabergoline.  I haven't been on cabergoline for too long but I had bloodwork done to test my levels, but I do notice that I do not seem to lactate anymore.  So will the puffiness go away?

[DrBermant]

I am also on cabergoline.  I had surgery to remove my prolactinoma which had prolactin levels above 577.  It settled to about 60 after surgery for a year.  I am young so I had genotropin and testosterone injections.  Now I am only on cabergoline hoping that it will bring my prolactin level into the normal range.  I hope that once the prolactin goes back to normal, that my testosterone and hgh go up on their own.  I have the same puffy problem.  I seriously hate it.  I'm now 6' 1" tall and 174lbs.  I have these puffy nipples and I want to know if that will go away on cabergoline.  I haven't been on cabergoline for too long but I had bloodwork done to test my levels, but I do notice that I do not seem to lactate anymore.  So will the puffiness go away?

If the gland is still tender / sore, there can still be swelling from hormonal stimulation. Once such stimulation is brought under control, then residual gland contour issues can be better assessed. Surgery on stable problems is so much better than ones still evolving. I prefer to wait until my patients' Endocrinologist has advised me that the medical problem is now stabilized.

Many have told me that No Surgery Body Shaping Garments has helped with contour issues until issues are stabilized.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction