Answers About Gynecomastia

— -- First, I wish to thank ABCNEWS for presenting this topic on national television. I have been deluged with thousands of e-mails from fellow sufferers and friends of sufferers. Although I can not respond individually to every e-mail, there are a number of frequently asked questions. I hope that the following questions and answers will help many of you.

Q: What exactly is gynecomastia and how do I know if I have it?

A: Gynecomastia is the presence of breast tissue in a male and it is often mixed with fatty tissue. It can occur in a newborn but frequently disappears. It often occurs during puberty and disappears in most young men, although it may persist forever in some of them. It can also occur later in life due to a variety of factors, which include use of bodybuilding steroids, marijuana, various medications, etc. Oftentimes it is due to hereditary factors. There are rarely severe hormonal irregularities. Gynecomastia is not related to obesity but may coincide with it. It may be as small as a firm area of tissue just under the nipple or as large as a DD cup pendulous breast.

Sometimes one can feel firm breast tissue under the nipple or in the surrounding chest area when the arm is stretched over the head. However, most often a doctor will be able to determine if you have gynecomastia.

Q: How is your procedure performed?

A: During my surgical training, I was disappointed in the usual surgical treatment for this problem, for many people were left with large scars or deformities which in some cases was worse than the original problem. As an answer, I designed my own set of surgical instruments specifically for this problem. In my hands, it is performed on an outpatient basis in my office operating room. The average case takes 90 to 120 minutes and is performed under "twilight sleep" sedation. Routinely there will be some swelling, bruising and temporary diminished feeling in the chest and the nipples. All of these symptoms subside within several weeks. The extra skin tightens by itself and the areola often shrinks in size. The pain after surgery has been described as " I feel like I just did 300 pushups." Most men are able to return to sedentary-type work within four to seven days after the surgery. A compression dressing is placed on the chest and worn under the clothing for approximately three weeks. Strenuous exercise and sports may begin three weeks after surgery. Complete healing may take up to three or four months.