Gyno question - k for help!

[Anthony Starks]

I have mild gyno that has not responded to letro and not being on any AS for over three months. I went to my general prac today and they felt the lumps and are going to refer me to another doc to run more tests. Am I wasting my time since I am 99% sure of what it is already? Any chance my insurance will pay for any of the surgery? What kind of price should I expect for surgery on mild gyno with no other lipo? On a side note, I'm done with AS for good.

 

[odoyal rulez]

I seriously doubt your insurance company will pay for anything cosmetic. I work with a multitude of medical insurance companies daily, and you'd have to have a miracle policy to cover that. Good luck though man.

 

[Anthony Starks]

I seriously doubt your insurance company will pay for anything cosmetic. I work with a multitude of medical insurance companies daily, and you'd have to have a miracle policy to cover that. Good luck though man.

Is there a way to increase the odds - complain of pain or something like that? What the hell do I have insurance for if they won't cover removing painful growths from my body?

 

[drbermant]

I have mild gyno that has not responded to letro and not being on any AS for over three months. I went to my general prac today and they felt the lumps and are going to refer me to another doc to run more tests. Am I wasting my time since I am 99% sure of what it is already? Any chance my insurance will pay for any of the surgery? What kind of price should I expect for surgery on mild gyno with no other lipo? On a side note, I'm done with AS for good.

I see many bodybuilders for gynecomastia. Surgery does not stop breast regrowth. Sculpting stable problems is better than recurrence and needing revision surgery. Recurrence after my sculpture is very uncommon.

I consider an endocrinology evaluation (testing) based on a good medical history. Honesty helps a doctor better understand possible causes. Someone who grew breasts and had discomfort using something like AS that stopped the growth and sensitivity when they stopped the medication often does not need such testing. Someone who continues with discomfort and growth after stopping may have other problems that factor into the gynecomastia that need evaluation to minimize the chance of regrowth.

It does not take much to disturb the cut look of someone with a low body fat % such as a bodybuilder and I have sculpted many. Bodybuilding can help with fat and muscles, but will not help with gland and you cannot pick where the fat comes from. My bodybuilding patients typically tell me that what is on top of the muscle gets pushed out further in making bigger muscles.

You can find some examples of pictures before and after gynecomastia surgery

Here - Gyno and BodyBuilding

Puffy Nipples and Bodybuilding

Here - Gynecomastia and BodyBuilding

Here - Gynecomastia Treatment

and

Here - Gynecomastia BodyBuilding.

I would suggest looking beyond each link's first page at all of the views for each patient to better understand the difference in the look before / after surgery. There are other examples of lean patients, but thought this would be a good start.

Recovery after surgery depends on the original problem, what was done, bruising, swelling, skill of the surgeon, aftercare, and how a patient heals.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

 

[Darth Pincho]

Doc i have one question. During the surgery do you extract the complete gland or not? for some bodybuilders who use AS about two times per year the gyne can grow again if the gland are not completely extracted.

What type of surgery do you recomend for bodybuilders wich use AS in order to prevent gyne appears again in the future?

 

[drbermant]

Doc i have one question. During the surgery do you extract the complete gland or not? for some bodybuilders who use AS about two times per year the gyne can grow again if the gland are not completely extracted.

What type of surgery do you recomend for bodybuilders wich use AS in order to prevent gyne appears again in the future?

Gynecomastia Surgery Does Not Prevent Regrowth


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.

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 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. With my techniques and red flag before surgery evaluation system, I have only a few patients over the many years I have been doing surgery that I know have regrown. 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
Learn More About Gynecomastia and Chest Sculpture

 

[Darth Pincho]

Ok doc i understand well that no method will provide 100% assurance in order to not have regrowth. But if im not wrong gynecomastia in the case of healthy bodybuilders is due to the aromatization of AAS. According to this, the estrogens produced by this aromatization bind to the gland in chest and promotes the growth.

If there is no gland due to a complete extraction in a surgery procedure there is not gonna be any gland growth? I understand that some gland tissue remains along the chest, but not the main gland mass. But im talking to minimize the risks in the future

Another thing, if the bodybuilder drop the bodyfat like in this pictures you have in your website, i mean ripped to the bone, the surgery procedure is easiest to you? you dont have to look hard to see gland and left fat, because there is no fat. And you can effectively remove more gland tissue? is this true or im not right?

http://www.plasticsurgery4u.com/procedure_folder/male_breast/gyno_bodybuilding.html

I need to know if there is an aditional advantage of droping body fat before take the surgery procedure? because that can take 2 months.

Thanks a lot for your patience, help, and time.

 

[drbermant]

Ok doc i understand well that no method will provide 100% assurance in order to not have regrowth. But if im not wrong gynecomastia in the case of healthy bodybuilders is due to the aromatization of anabolic androgenic steroids. According to this, the estrogens produced by this aromatization bind to the gland in chest and promotes the growth.

If there is no gland due to a complete extraction in a surgery procedure there is not gonna be any gland growth? I understand that some gland tissue remains along the chest, but not the main gland mass. But im talking to minimize the risks in the future

Another thing, if the bodybuilder drop the bodyfat like in this pictures you have in your website, i mean ripped to the bone, the surgery procedure is easiest to you? you dont have to look hard to see gland and left fat, because there is no fat. And you can effectively remove more gland tissue? is this true or im not right?

http://www.plasticsurgery4u.com/procedure_folder/male_breast/gyno_bodybuilding.html

I need to know if there is an aditional advantage of droping body fat before take the surgery procedure? because that can take 2 months.

Thanks a lot for your patience, help, and time.

Typically getting to a weight you are comfortable with is best before surgery than after. You cannot predict where fat from weight loss comes from or goes on with weight gain. The exception is for extreme bodybuilding and athletes with extremely low body fat. For these patients, I prefer their off season fat as a sculpting tool so I can target more gland. When there is no fat, I may need to leave some gland behind to minimize the chance for a crater deformity.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

 

[Ralph_Wiggum]

Typically getting to a weight you are comfortable with is best before surgery than after. You cannot predict where fat from weight loss comes from or goes on with weight gain. The exception is for extreme bodybuilding and athletes with extremely low body fat. For these patients, I prefer their off season fat as a sculpting tool so I can target more gland. When there is no fat, I may need to leave some gland behind to minimize the chance for a crater deformity.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

not sure if it helped him, but it answered a question I always had. Thanks.