hackskii

Gynecomastia-Male Breast Development.

By: Bruce J. Nadler M.D.

Several years ago my answering service called to tell me the number of obscene telephone calls that were coming through on my line alarmed them. They went on to explain that the calls all started on normally but then all of these young men started to use foul language. They couldn't believe the number of different people doing this. I thought for a moment and then asked if the term they heard was "bitch tits." "Yes that is exactly what they say" was the reply.

With a big smile I explained to them that these were just patients expressing a medical condition. Gynecomastia, bitch tits or "the bodybuilder's tumor" all mean the same thing, the embarrassing development of male breasts.


Gynecomastia

The treatment of gynecomastia has become a specific interest of mine due to all the bodybuilders I treat. I have long ago set the world's record in performing these surgeries and have lectured to other surgeons on my techniques.

It is a problem that has existed through antiquity. Ancient hieroglyphics show the condition on several of the Pharaohs. It is not all that uncommon. The Navy did a study during World War II and classified one quarter of their recruits as having excessive breast tissue.


Seated Statue Of Amenhotep IV (Akhenaten)
Dynasty 18, 1353-1337 BC
Click To Enlarge.

Causes

The condition can occur naturally or as a side effect of anabolic steroids and other medications. It has also been implicated with the excessive use of marijuana.

The use of anabolic steroids is especially implicated. Of course not all steroids will cause it, only the ones that aromatize. Anadrol, Sustanon and Dianabol are especially known causes. Some others are weaker stimulators and are dose related.

When gynecomastia occurs naturally, it is a slower process and usually consists of both glandular and fatty tissue. Anabolic steroid induces gynecomastia occurs much more rapidly and is usually a sheet of pure glandular tissue. Of course there is a range between these extremes

When the body senses too much testosterone or a testosterone like substance, it tries to reduce the level by a process called aromitization. This converts the testosterone to estradiol, an estrogen like substance. All men have some glandular tissue. If there is also genetic receptor sensitivity, the increased estradiol level will stimulate this tissue to grow.

Symptoms

It is first noticed as some sensitivity in the nipple area often going on to real discomfort. As the tissue further develops, the area will swell and extend laterally under the arm. The condition can run the range from a mass under the nipple with perhaps some coning to fully developed breasts.

It is most noticeable when you least want it to be. If the weather is cold, everything tightens up. But in the warm weather, when you want to take your shirt off, it all pouts forward and is noticeable.

I've lost track of the number of my patients who continuously pinched themselves or used ice cube and cold water to keep things from being too noticeable. Estrogen blockers like Nolvadex or Arimidex can prevent the occurrence but only surgery can cure it.

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Surgery

The surgery consists of a combination of liposuction and direct glandular excision through a small incision at the nipple border. Beware of any surgeon who claims to be able to treat it with liposuction alone. I have had to operate on many patients who have had this previous surgery elsewhere.

Liposuction merely removes the fatty component and after the swelling subsides, you merely have a smaller version of what was there before.

I have also seen patients scarred across the entire chest and others who have had parts of their pectoral muscles removed.

It is done under general anesthesia and lasts about 2 hours. Liposuction is first done to remove the fatty component allowing the glandular tissue to condense. A small incision is then made at the lower nipple border.

The glandular tissue is then carefully removed tracing the extension under the arm. Too many inexperienced surgeons fail to do this creating a crater in the middle of the chest. A small amount of glandular tissue is left just behind the nipple to prevent collapse and indentation.

Often suction drains are used for the first few post-operative days to prevent fluid collection is the pocket previously occupied by the tissue. I do all the suturing with dissolving, buried sutures to minimize scarring and avoid that railroad track look. A compression vest is worn for several weeks to control the skin shrinkage.

Post Surgery Health

It is very important to be off any anabolic cycle for at least 6 weeks prior to the surgery. Anabolic steroid side effects such as slowing of blood clotting and increased blood pressure add to the possibility of surgical complications. In addition altered liver chemistry due to some anabolics can add to the risk of anesthesia.

Low impact aerobic activity can resume in a week. Light weight training can resume in 3 weeks with the exception of chest and back. Chest and back can start lightly at 4 weeks and full routines can be resumed at 6 weeks.

It is my greatest pleasure when the patients can tell me they can happily walk around with their shirts off.

For more information I can be contacted at 1-800-445-0505 or through my web site at Bruce J. Nadler M.D. Aesthetic Plastic Surgery.

Bruce J. Nadler M.D.

__________________
Power over others is weakness disguised as strength.

Scott

Flex Factor

Just wondering if anyone else has an opinion on this as i've noticed that in other threads arimidex and letro have been detailed as actually stopping/reversing gyno.

Is this to say that once an individual experiences gyno, or a level of gyno (i.e. cone like nipples and swelling under arm), it will be impossible to reverse without surgery?

Any viewpoints appreciated.

SD

I think lumps are pretty irreversible without surgery but gyno symptoms, itching, pain, slight swelling can definately be reversed with an AI or SERM.

SD

Flex Factor

Would that go for the cone like nipples and swelling?

Cheers mate.

SD

Hmm, never had that, I think from the description its just swelling so yes it should go, only hard fibrous lumps need surgery (hopefully).

SD

brownie

ya i have 2 hard lumps under my nipples,.. but they are not visible to look at but i can feel them. this happened on my first cycle, i always use an AI now

PHHead

I have this very mildly mate from Anadrol and am currently taking Letro to get rid of it, I will let everyone know how it goes!

Flex Factor

Wicked. Cheers mate.

Keep me informed of how you react to the letro too - no sex drive wise, as i'm already getting the usual 'You've changed' from her as it is.

Sylar

Letro will reverse early stage gyno, including small gyno lumps.

Once it turns fibrous, you'll need to go under the knife like said above. (People do use Letro to reduce fibrous gyno though, but it will not reverse it..)

hackskii

Remember too, that this dude makes his money on surgery.....
I myself as well as many others have in fact reversed my gyno with the use of letro.
I know another guy on this board that reversed his with adex.

I will tell you that the letro killed my sex drive flat, also got some freaking bad stiff joints (they are generally a bit stiff anyway).
Remember as well, that estrogen is necessary for good lipid profiles and supports bone, so prolonged use may compromise these.

__________________
Power over others is weakness disguised as strength.

Scott

Flex Factor

Do you reckon reverse as well as prevention could take place in my next cycle when i incorporate an AI?

What i mean is - i'm not really sure if i have true gyno - i am experiencing cone like nipples and slight swelling but nothing too extreme.

However i am due to start another cycle in 5 weeks and will be using 0.5mg Arimidex EOD together with 600mg Test E per week (for 10 weeks), followed by 300mg Test Prop per week (100mg EOD). I will finish with a PCT of Clomid (100/100/50) and Nolvadex (40/20/20/20/20). What i'm wondering is if the use of Arimidex and the PCT in this cycle will help combat/help if not totally reverse the gyno i probably have?

hackskii

No doubt using an AI during an aromitizable cycle would be a good idea, this I have found works better for recovery beings that estrogen in itself is so supressive.

Doubtful that .5 EOD will reverse the gyno during a cycle.
that would probably be enough to keep estrogen sides at bay.

__________________
Power over others is weakness disguised as strength.

Scott

Flex Factor

What you recommend mate? Am open to ideas - as you can see i'm looking to prevent further gyno and possibly reduce or reverse what gyno i have.

Cheers.

hackskii

I would try and reduce the gyno in between the cycles, then use some estrogen management during the cycle.

I guess you could do 2.5 letro during your cycle, but I think you would have better odds doing it in between.
For adex it would be 1mg a day, I know a guy that reversed his that way.

__________________
Power over others is weakness disguised as strength.

Scott

Flex Factor

Wicked. I'm going to opt for the arimidex for now (as am already in the misus bad books) and get on it straight away - 1mg every day for next 5 weeks until next cycle starts. Will keep it going throughout the cycle then either at 0.5mg or 1mg EOD.

Cheers mate.