A Thread Devoted To Gynecomastia

Discussion in 'Men's Health Forum' started by BBC3, Mar 26, 2011.

  1. BBC3

    BBC3 Member

    Sorry I see not link above and I CANT FIND IT...

    I am just adding at this point, that being in as shitty shape as I have EVER been in, NO AMOUNT of testosterone dosed as exogenous can spur a flare of my TEET. Go figure. I must be dying... But it seems correlated to overall hormone demand and delivery to the breast potential area if you ask me. All other conditions are the same as before... Except that I could give a shit to manually tweek it in any way as of late...
     
  2. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Song YN, Wang YB, Huang R, et al. Surgical Treatment of gynecomastia: Mastectomy Compared to Liposuction Technique. Ann Plast Surg. Surgical Treatment of Gynecomastia: Mastectomy Compared to L... : Annals of Plastic Surgery

    BACKGROUND: Gynecomastia was a benign enlargement of the male breast. Yet, the enlarged breasts caused much anxiety, embarrassment, psychosocial discomfort, and fear of breast cancer. The aim of this study was to assess the experience of gynecomastia patients undergoing mastectomy and liposuction surgery.

    METHODS: Seven hundred thirty-three patients were analyzed for age, chief complaint, position, grade, operation approach, biopsy, and complication between mastectomy group and liposuction group, from 1990 to 2010.

    RESULTS: Four hundred two patients (436 breasts) were treated with mastectomy and 331 patients (386 breasts) were treated with liposuction techniques. Three hundred thirty (82%) patients complained of breast lump and lump with pain in mastectomy group, and 204 (61%) patients complained of enlargement breast and enlargement with pain in liposuction group (P < 0.05). All excision specimens were performed for routine histological analysis which showed pathologic diagnosis in patients with mastectomy (100%). One hundred fifty-nine (41%) patients with liposuction acquired pathologic diagnosis through fine needle aspiration and/or core biopsy (P < 0.05). The reoperation rates in mastectomy group and liposuction group were 1.4% and 0.5%, respectively. There were no nipple/areola necrosis and scars in liposuction group.

    CONCLUSIONS: The surgical treatment of gynecomastia required an individual approach, depending on symptoms (lump or enlargement) and requirements of patients. Patients who chose mastectomy were looking for reassurance that their pathologic diagnosis was benign. The increase in the number of liposuction patients was reflected in our study because it was associated with superior esthetic results and few complications.
     
  3. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Song YN, Wang YB, Huang R, et al. Surgical Treatment of gynecomastia: Mastectomy Compared to Liposuction Technique. Ann Plast Surg. Surgical Treatment of Gynecomastia: Mastectomy Compared to L... : Annals of Plastic Surgery

    BACKGROUND: Gynecomastia was a benign enlargement of the male breast. Yet, the enlarged breasts caused much anxiety, embarrassment, psychosocial discomfort, and fear of breast cancer. The aim of this study was to assess the experience of gynecomastia patients undergoing mastectomy and liposuction surgery.

    METHODS: Seven hundred thirty-three patients were analyzed for age, chief complaint, position, grade, operation approach, biopsy, and complication between mastectomy group and liposuction group, from 1990 to 2010.

    RESULTS: Four hundred two patients (436 breasts) were treated with mastectomy and 331 patients (386 breasts) were treated with liposuction techniques. Three hundred thirty (82%) patients complained of breast lump and lump with pain in mastectomy group, and 204 (61%) patients complained of enlargement breast and enlargement with pain in liposuction group (P < 0.05). All excision specimens were performed for routine histological analysis which showed pathologic diagnosis in patients with mastectomy (100%). One hundred fifty-nine (41%) patients with liposuction acquired pathologic diagnosis through fine needle aspiration and/or core biopsy (P < 0.05). The reoperation rates in mastectomy group and liposuction group were 1.4% and 0.5%, respectively. There were no nipple/areola necrosis and scars in liposuction group.

    CONCLUSIONS: The surgical treatment of gynecomastia required an individual approach, depending on symptoms (lump or enlargement) and requirements of patients. Patients who chose mastectomy were looking for reassurance that their pathologic diagnosis was benign. The increase in the number of liposuction patients was reflected in our study because it was associated with superior esthetic results and few complications.
     
  4. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [​IMG]
     

    Attached Files:

    twistulikepretzel and BBC3 like this.
  5. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Lapid O, Jolink F, Meijer SL. Pathological Findings in gynecomastia: Analysis of 5113 Breasts. Ann Plast Surg. Pathological Findings in Gynecomastia: Analysis of 5113 Brea... : Annals of Plastic Surgery

    OBJECTIVE: This study aimed to analyze the histopathology results of surgically excised breast specimens with the diagnosis of gynecomastia (GM).

    SUMMARY BACKGROUND DATA: Gynecomastia is a term used to describe benign hypertrophy of the breast in men; it is a common, mostly transient, phenomenon in adolescents, but may also be seen in older men. Breast enlargement can lead to psychological problems; if it persists it can be surgically corrected. The obtained breast tissue specimens are routinely submitted for pathological examination. We performed this study to assess the prevalence of pathological findings after surgical management of GM.

    METHODS: Pathology reports were obtained from the nationwide network and registry of histopathology and cytopathology in the Netherlands (PALGA). The reports of 5113 breasts were analyzed for the prevalence of pathologies in different age groups.

    RESULTS: The average age of the patients was 35.3 +/- 18.3 years (range, 1-88 years). The most common finding was GM followed by pseudo-GM. The overall prevalence of invasive carcinomas was 0.11% and of in situ carcinomas was 0.18%. The youngest patient with invasive cancer was 65 years old and the youngest patient with carcinoma in situ was 24 years old. The overall prevalence of atypical ductal hyperplasia was 0.4%; in patients younger than 20 years, it was 0.23%. The youngest patient with atypical ductal hyperplasia was 16 years old. Pathological findings were found more often in unilateral procedures.

    CONCLUSIONS: The prevalence of malignancies in GM resection specimens is low; however, it increases with patient age. Unilateral cases have a statistically nonsignificant higher prevalence of pathologies.
     
  6. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Hormones Affecting Growth and Differentiation of Breast Tissue
    Chapter

    [​IMG]
     

    Attached Files:

  7. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Cao H, Yang ZX, Sun YH, Wu HR, Jiang GQ. Endoscopic subcutaneous mastectomy: A novel and effective treatment for gynecomastia. Exp Ther Med 2013;5(6):1683-6. Endoscopic subcutaneous mastectomy: A novel and effective treatment for gynecomastia

    The aim of this study was to evaluate the procedure for and efficacy of endoscopic subcutaneous mastectomy for gynecomastia. Endoscopic subcutaneous mastectomy was performed on 100 benign, palpable breast enlargements in 58 male patients who were followed-up for 15-63 months. The surgery was conducted with the insufflation of CO2 subdermally. No cases were converted to open surgery. The unilateral surgery time was 70-90 min. The mean volume of the resected tissue was 200 ml. All procedures were completed successfully, with satisfactory clinical effects and ideal esthetic results postoperatively. There were three cases (3%) of papillary epidermal partial necrosis; following removal of the dressing during the hospital stay, normal nipple sensation returned. Endoscopic subcutaneous mastectomy had good clinical effects and ideal cosmetic results and is an appropriate approach for gynecomastia.
     
    beezil likes this.
  8. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Mieritz MG, Sorensen K, Aksglaede L, et al. Elevated serum IGF-I, but unaltered sex steroid levels, in Healthy Boys with Pubertal Gynaecomastia. Clinical Endocrinology. Elevated serum IGF-I, but unaltered sex steroid levels, in Healthy Boys with Pubertal Gynaecomastia - Mieritz - Clinical Endocrinology - Wiley Online Library

    Objective Pubertal gynaecomastia is a very common condition. Although the underlying etiology is poorly understood, it is generally accepted that excess of estrogens and/or deficit of androgens are involved in the pathogenesis. Furthermore, adiposity as well as the GH/IGF-I axis may play a role. In the present study we elucidate the association of adiposity and levels of FSH, LH, SHBG, testosterone, E2, IGF-I, and IGFBP-3 with the presence of pubertal gynaecomastia in a large cohort of healthy boys.

    Patients 501 healthy Danish school boys (aged 6.1-19.8 yr) from the COPENHAGEN Puberty Study.

    Measurements Anthropometry and pubertal stages (PH1-6 and G1-5) were evaluated, and the presence of gynaecomastia was assessed. Body fat percentage was calculated by means of four skin folds and impedance. Non-fasting blood samples were analyzed for FSH, LH, testosterone, SHBG, estradiol, IGF-I, IGFBP-3 and prolactin.

    Results We found that 23% (31/133) of all pubertal boys had gynaecomastia. More specifically 63% (10/16) of boys in genital stage 4 had gynaecomastia. Boys with gynaecomastia had significantly higher IGF-I levels compared to controls (IGF-I SD-score 0.72 vs. -0.037, p<0.001). This difference was maintained after adjusting for confounders (age and pubertal stage). Sex steroid levels, estradiol/testosterone-ratio, or free testosterone were not associated with the presence of gynaecomastia with or without adjustment for confounders.

    Conclusions IGF-I levels were elevated in healthy boys with pubertal gynaecomastia compared to boys without gynaecomastia, whereas sex steroid levels did not differ. We speculate that the GH-IGF-I axis may be involved in the pathogenesis of pubertal gynaecomastia.
     
  9. AG434

    AG434 Junior Member

    All this gynecomastia talk is getting me worried. What type of specialist should I see, and what should I tell them do to? Bloodwork?
    Thanks inadvance, Doc.
     
  10. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Maseroli E, Rastrelli G, Corona G, et al. gynecomastia in subjects with sexual dysfunction. J Endocrinol Invest. Gynecomastia in subjects with sexual dysfunction - Online First - Springer

    PURPOSE: To analyze possible relationships between gynecomastia and clinical and biochemical parameters in a large cohort of subjects with sexual dysfunction (SD).

    METHODS: A consecutive series of 4,023 men attending our Outpatient Clinic for SD was retrospectively studied.

    RESULTS: After excluding Klinefelter's syndrome patients, the prevalence of gynecomastia was 3.1 %. Subjects with gynecomastia had significantly lower testosterone (T) levels; the association retained statistical significance after adjusting for age and life-style. However, only 33.3 % of subjects with gynecomastia were hypogonadal. Gynecomastia was associated with delayed puberty, history of testicular or hepatic diseases, as well as cannabis abuse. Patients with gynecomastia more frequently reported sexual complaints, such as severe erectile dysfunction [odds ratio (OR) = 2.19 (1.26-3.86), p = 0.006], lower sexual desire and intercourse frequency [OR = 1.23 (1.06-1.58) and OR = 1.84 (1.22-2.78), respectively; both p < 0.05], orgasm difficulties [OR = 0.49 (0.28-0.83), p = 0.008], delayed ejaculation and lower ejaculate volume [OR = 1.89 (1.10-3.26) and OR = 1.51 (1.23-1.86), respectively; both p < 0.05]. Gynecomastia was also positively associated with severe obesity, lower testis volume and LH, and negatively with prostate-specific antigen levels. The further adjustment for T did not affect these results, except for obesity. After introducing body mass index as a further covariate, all the associations retained statistical significance, except for delayed ejaculation and ANDROTEST score. When considering gynecomastia severity, we found a step-wise, T-independent, decrease and increase of testis volume and LH, respectively. Gynecomastia was also associated with the use of several drugs in almost 40 % of our patients.

    CONCLUSION: Gynecomastia is a rare condition in subjects with SD, and could indicate a testosterone deficiency that deserves further investigation.
     
  11. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Brinton LA, Cook MB, McCormack V, et al. Anthropometric and Hormonal Risk Factors for Male Breast Cancer: Male Breast Cancer Pooling Project Results. J Natl Cancer Inst. Anthropometric and Hormonal Risk Factors for Male Breast Cancer: Male Breast Cancer Pooling Project Results

    BACKGROUND: The etiology of male breast cancer is poorly understood, partly because of its relative rarity. Although genetic factors are involved, less is known regarding the role of anthropometric and hormonally related risk factors.

    METHODS: In the Male Breast Cancer Pooling Project, a consortium of 11 case-control and 10 cohort investigations involving 2405 case patients (n = 1190 from case-control and n = 1215 from cohort studies) and 52013 control subjects, individual participant data were harmonized and pooled. Unconditional logistic regression generated study design-specific (case-control/cohort) odds ratios (ORs) and 95% confidence intervals (CIs), with exposure estimates combined using fixed effects meta-analysis. All statistical tests were two-sided.

    RESULTS: Risk was statistically significantly associated with weight (highest/lowest tertile: OR = 1.36; 95% CI = 1.18 to 1.57), height (OR = 1.18; 95% CI = 1.01 to 1.38), and body mass index (BMI; OR = 1.30; 95% CI = 1.12 to 1.51), with evidence that recent rather than distant BMI was the strongest predictor. Klinefelter syndrome (OR = 24.7; 95% CI = 8.94 to 68.4) and gynecomastia (OR = 9.78; 95% CI = 7.52 to 12.7) were also statistically significantly associated with risk, relations that were independent of BMI. Diabetes also emerged as an independent risk factor (OR = 1.19; 95% CI = 1.04 to 1.37). There were also suggestive relations with cryptorchidism (OR = 2.18; 95% CI = 0.96 to 4.94) and orchitis (OR = 1.43; 95% CI = 1.02 to 1.99). Although age at onset of puberty and histories of infertility were unrelated to risk, never having had children was statistically significantly related (OR = 1.29; 95% CI = 1.01 to 1.66). Among individuals diagnosed at older ages, a history of fractures was statistically significantly related (OR = 1.41; 95% CI = 1.07 to 1.86).

    CONCLUSIONS: Consistent findings across case-control and cohort investigations, complemented by pooled analyses, indicated important roles for anthropometric and hormonal risk factors in the etiology of male breast cancer. Further investigation should focus on potential roles of endogenous hormones.
     
  12. BBC3

    BBC3 Member

  13. MR10X

    MR10X Member

    BBC3 likes this.
  14. Nordeast05

    Nordeast05 Junior Member

    Hey guys! Long time follower first time poster. Since I was 13 or 14 my nipples have always been pointy (I can see them through any shirt) but to other people it's not incredibly noticeable. I have been lifting for 6 years, I have reduced my body fat and improved posture and it's helped alot. At 18 I was 140 18ish% bf now I'm 180 14ish% bf. Either way, I saw an endo around 8 months ago, he confirmed it was mild gyno, but he wasn't willing to experiment with any SERMS. And if there are studies showing SERMS don't have effect with gyno from puberty, I understand his reasoning (although I've never found one of those studies.) The reason I'm posting is because during my searching I found this article. http://www.worldclassbodybuilding.com/forums/showthread.php?t=81608

    I don't know who Eric potratz is, but he claims all gyno is reversible and that he did it with a ton of clients. What are your guys' opinions? Hopefully a Doc can chime in.

    I notice that if I get above 15% bf my moobs become noticeable to everyone. Because of this, I have spent a lot of that past 6 years spinning my wheels. I try to bulk but once I hit a certain point my moobs pop and I panic and cut back down. I am 6'1" and was super lanky/ skinny fat. I picked up test-e (500mg/week as recommended by your well know members for a first cycle) liquidex and nolvadex. Partially because that article says there is a chance of reversing my gyno (don't worry I am super skeptical) but mostly because I want some size and I can't handle gaining fat too. I expect some people will tell me not to cycle and to bulk until I reach my genetic potential, but I hope I've explained why I don't want to do that so much.
    My main questions are:

    Do you think Eric Potratz's methods and reasoning for them are bs?

    Is there anything soecial I should be watching for during this cycle since I got gyno during puberty?

    Here's some pictures. Do you guys think that since my gyno is mild, getting below 10% bf would be enough for them to not be noticeable?

    (It might be hard to tell but the entire lower portion of my pet is fat, and like I said before I saw an endo and regardless of the fat, i don't have pseudogynecomastia)

    Any replies would be extremely appreciated! Thanks guys!
     

    Attached Files:

  15. tileguy123

    tileguy123 Member

    those arent bad.. at all
     
  16. Jimmyhoffa59

    Jimmyhoffa59 Member

    Im 35, as soon as I hit puberty around 12 my nipples became extremely puffy and rounded out. It has literally been tormenting my whole adolescent and adult life, I was always lean until I was 26. They are large fibrous lumps Id say golf ball size honestly.

    Spending my teen years praying to not be on "skins" team or mastering the art of the slight of hand nipple pinching to keep them hard has been my life.

    I approached my doctor at the VA and convinced them to put me through to the surgery, after a mammogram lol and tests I plan to have the surgery next year, and it'll be free;thanks friendly tax payers lol.

    I can't imagine how nice it will feel to never deal with that shitty feeling again. I'll save the glands and cook em and feed them to some asshole low doser ugl if I ever track one down.:D
     
    tileguy123 likes this.
  17. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Blau M, Hazani R. Correction of gynecomastia in body builders and patients with good physique. Plast Reconstr Surg 2015;135(2):425-32. http://goo.gl/oUWrKm

    BACKGROUND: Temporary gynecomastia in the form of breast buds is a common finding in young male subjects. In adults, permanent gynecomastia is an aesthetic impairment that may result in interest in surgical correction. Gynecomastia in body builders creates an even greater distress for patients seeking surgical treatment because of the demands of professional competition. The authors present their experience with gynecomastia in body builders as the largest study of such a group in the literature.

    METHODS: Between the years 1980 and 2013, 1574 body builders were treated surgically for gynecomastia. Of those, 1073 were followed up for a period of 1 to 5 years. Ages ranged from 18 to 51 years. Subtotal excision in the form of subcutaneous mastectomy with removal of at least 95 percent of the glandular tissue was used in virtually all cases. In cases where body fat was extremely low, liposuction was performed in fewer than 2 percent of the cases.

    RESULTS: Aesthetically pleasing results were achieved in 98 percent of the cases based on the authors' patient satisfaction survey. The overall rate of hematomas was 9 percent in the first 15 years of the series and 3 percent in the final 15 years. There were no infections, contour deformities, or recurrences.

    CONCLUSIONS: This study demonstrates the importance of direct excision of the glandular tissue over any other surgical technique when correcting gynecomastia deformities in body builders. The novice surgeon is advised to proceed with cases that are less challenging, primarily with patients that require excision of small to medium glandular tissue.
     
  18. bdg77

    bdg77 Member

  19. MidnightZ06

    MidnightZ06 Member

    When I was 13 I was entering puberty stage of course and I noticed I always had puffy nipples. And small lumps underneath. Many years went by and I was in my twenties and I used to get very very bad chest pains and it worried me so much I ended up going to the ER complaining of chest pain they did the usual test EKG, CT Scan etc doctor walks in and says well I see masses in your chest and at first he thought it was a clot. And said you have gyno I didn't know what it was until I did some research on it. I grew up very poor as a kid so going to the doctor was out of the question so seeking help was not an option at the time. Now I'm 31 years old still have gyno and of course I lift weights as my chest continues to develop the only thing that still concerns me is my puffy nipples. I would not mind going to see a doctor what I'm not sure what they could for me aside from surgery. I guess from my findings is that some kids get it and it goes away for me it did not and I was a skinny kid obesity does not run in my family at all. Come from a family of thin weight.