Can Unilateral Gynecomastia be treated with prescription from a Doctor or is surgery the only option? (photos)

Question

In august of this year i had noticed that my right nipple was puffy and upon squeezing had leaked out milky fluid. I was referred to an endocrinologist, where we established the culprit of my condition, was from a sports supplement used for endurance. I've had all the tests and i was diagnosed with high Prolactin levels of 23 ng/ l and am currently taking Cabergoline for those symptoms. Although now i have developed a mass behind the nipple, that is 2 cm in size. is Surgery the only option?

Jed H. Horowitz, MD, FACS · Answer

The most common and reliable method to correct gynecomastia, is surgery.There are three types of surgical #treatment #options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate. #Assymetric or Unilateral Gynecomastia appears in either one or both breasts at different degrees. In many cases one breast appears larger than the other. Surgery is a common treatment for this type of gynecomastia.

Also, "Puffy Nipple Areola Complex" is among the most common forms of gynecomastia. This gland and/or adipose tissue accumulation can be located under the areola or can be slightly extended outside the areola, causing the areola to appear dome shaped. This form of #Gynecomastia can be found in all age groups but is more common in young adults. Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.As each case is different, it is vital that you consult with a board certified plastic surgeon who is experienced in male breast surgery. The surgeon should determine if you are a suitable candidate for male breast reduction by liposuction or glandular excision. It is also crucial to have a plastic surgeon who is well-versed in the gynecomastia condition can determine if there is firm breast tissue beneath the areola that is causing the nipples to project (which is often the case), and if so, how much of this glandular tissue can be removed to create a flat appearance.#PuffyNipple surgery generally takes only an hour or two, and the recovery time is short; sometimes less than a week. There is minimal scarring and the success rate is excellent. Therefore, patients who suffer from "Puffy Nipples", and who view it as an unaesthetic and unpleasant condition, may desire surgical intervention to correct the "puffy nipple" condition.

Andrew Wolfe, MD · Answer

Yours is not an uncommon scenario -- I see many men who come in with complaints of gynecomastia after various supplements or steroids.  It is often bilateral, but can obviously be more prominent on one side.  If your prolactin levels are high, I would wait to see how the breast gland behaves once your levels are back within normal range.  You may find that the gland settles down.  If the mass stays prominent, however, then surgery is your only option.  Find a Plastic Surgeon with significant experience in gynecomastia surgery for a consultation if necessary.

Jonathan Weiler, MD · Answer

Surgery is the only option, once your tissue has " hypertrophied" or grown a excision is the only option, unfortunately many men are taking OTC supplements which result in glandular growth as these supplements are not FDA regulated.....good luck and seek a BC PS who does lots of this type of work!

Derby Sang Caputo, MD · Answer

Hello,  thank you for your question and photo.  As for the first option should be to stop any supplement for training purposes.   If the mass persist after 3-6 months  (is very probably that it does) then think about the surgery option for gynecomastia treatment.

Elliot W. Jacobs, MD · Answer

Fortunately, you have established a reasonable cause for the growth -- and yes, the body can be capricious and only grow on one side.Cabergoline is used mainly for a prolactinoma, a benign tumor of the pituitary gland -- which continually secretes prolactin.  This can only be diagnosed with an MRI of the brain.  Your case is different.  Presumably, the prolactin was due to your ingestion of supplements and if you have stopped the supplements, then more than likely your prolactin levels will fall and so will your need for Cabergoline.As for the breast growth, it would be wise to stop all supplements and observe for about one year.  If the tissue is still present, then the only option would be surgery.For further info about gynecomastia, please see my website, which is entirely devoted to the treatment of gynecomastia.Good luck!Elliot W. Jacobs, MD, FACSNew York City

Morad Tavallali, MD, FACS (retired) · Answer

Your best option is removal of the excess breast tissue surgically. The scar can be imperceptible inf placed around the areola. I do not know of any pill or cream that will decrease the size of the breast tissue.Best of luck!

Andrew Kaczynski, MD (retired) · Answer

It is unfortunate that once glandular tissue is established, there is no medical treatment for it.  Medication may correct some of the hormonal abnormalities but it does nothing to regress the tissue. The only correction possible at this time is with an incision at the bottom part of the areola Through there the gland can be removed  easily . Your best option is to contact a board-certified plastic surgeon who has experience in male breast surgery.

Jay M. Pensler, MD - Account Suspended · Answer

Sports supplements particularly supplements which are made outside of the USA or contain significant components made outside the USA can cause hormonal abnormalities. When masses develop as a result of supplementation or hormone ingestion they are typically glandular in nature ( breast tissue ) as opposed to fat and do not resolve without surgery.

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