trickassmark said:
I am not sure what I should do first... surgery or cycle?
My gyno is to the point that if it got any bigger than I wouldn't be able to take my shirt off even, and I know the surgery is way worse if they're big...
If I did get surgery before the cycle I would have to be absolutely sure that it wasn't going to come back. The reason I got gyno in the first place is because of shitty pct.
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 with my techniques. 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. 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
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