Gynecomastia Surgery

MidwestBeast

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Well, I was conflicted on whether or not to make this thread. Ultimately, I decided making it would hopefully be therapeutic for me and helpful for others. Next month, I will be having surgery to remove bi-lateral gynecomastia that is the result of a prolactinoma (small tumor on my pituitary gland that elevated my prolactin levels out of range prior to being treated with cabergoline).

This is typically a subject that isn't discussed out in the open very often due to stigmas and just one being generally uncomfortable with it. I won't lie and say I'm completely comfortable with everything, but it also is what it is and I would rather talk with those who have questions or those who have been in a similar position. The biggest thing is just having breast tissue (and not just the fat tissue, but actual mass behind the nipple on each side) as a man is not something that's easy to mentally deal with; particularly when you are someone who takes great efforts to stay in shape. Next is the fact that 99% of people who notice it will immediately jump to the conclusion of steroid-use because of my body. So that adds another layer of wanting to basically hide it from the world as much as possible. It's bad enough that I don't want to wear a lot of the shirts that you have because the way they rest, you can see it. Top that off with if you DO happen to wear that shirt, everyone is like "yeah, that guys uses steroids." And to be clear, I have no issue with steroid-use at all and think it should be legalized. I've ran a couple PH cycles in the past (epi), but that's been years. So A.) this never came from that and B.) even if I did cycle, I'd be smart enough to use the appropriate supports lol.

Anyway, I've never had elevated E2 levels; this is purely PRL driven. When it first popped up, I had tried to combat the little lump with letro and since several years ago when this first showed up, it's grown noticeably. The caber absolutely squashed the PRL levels, but the problem was the time it took my doc to prescribe it and I was trying to go proper channels on everything and do it by the book; hence not acquiring anything by other means.

After it was evident that it was beyond the point of reversal via medicine and surgery was the only option, I just waited on it for a good long while. I just wanted to put it off and I guess partially thought ignoring that would make it less real (irrational, but I can at least recognize it). At the beginning of the year, I met with my GP and had full panels of blood work done and everything was normal and in order (including PRL). I went ahead and discussed the option with him knowing that surgery was pretty much the next step but wanted his advice. He referred me to a surgeon (actually the same guy who had done my colonoscopy about 3 years ago). This doc is a nice guy and works at my gym of all things. So I met with him and our meeting lasted all of about 5 minutes. He told me that he could do the surgery, but that it wasn't an area of specialty for him -- "I can remove the mass; that's not a problem. But I can't guarantee you what it will look like after the fact -- and I don't want to mess that up with how much work you've put into your body." I appreciated the honesty and was thinking it may have gone this way anyhow, but was hoping it wouldn't so that I could ride it out with insurance. So he tells me he knows two plastic surgeons that he would recommend. I asked if he had a preference of one over the other (one was about twice as far away from us). He said if he had to trust his family member with one, it would be the guy who was twice as far away -- and I said that's who i wanted. They booked the initial consult and it was a 3 month wait. I just finally met with him.

So I'll be paying out of pocket, but I have to say I felt pretty comfortable with everything after talking with the doctor and his main nurse. It was one of those things where in all of the random little details and talking to people, I just had an inner sense of knowing that's where I was supposed to be (his main nurse actually met the doctor through his wife at bible study after the nurse had stopped doing nursing for a few years to attend Seminary -- I liked that). He ended up talking with me about the possible options and what we'll be doing (per his recommendation) is an incision underneath the chest and then a "pull-through" method to remove the mass along with lipo-suction to remove the fat around the mass. It should take about an hour.

So, as it stands, the procedure will be a few weeks away and I'll update this throughout the process. I know you see a lot of threads on the forums about gyno via PH/AAS usage. This isn't that, but regardless, the outcome is still the same. Hopefully this can serve as a resource when it comes to surgery.
 
MidwestBeast

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Had my pre-op appointment with the doc on Friday.

It was pretty basic stuff and since the turnaround on the surgery from the initial appointment was so quick, there wasn't really much new to discuss.

His main nurse got me squared away with some specifics of arrival time, making sure not to wear jewelry, etc. She had me try on the compression vests to find the right fit and then sent us home with some gauze pads, etc. along with my pain med scrips (so I can fill them prior to surgery and have them on hand).

My surgery is slated for about 1 PM, but she told me it may likely be pushed a bit further back since I'm at the end of the day and it usually just pushes back a bit (I appreciated the honesty and the heads up on that). Should be an hour or less; recovery for about 45 minutes and then heading home (my wife will drive me; the specialist is a little over an hour away from where we live, so no making me stay over night in case of emergency like they'd typically do if I lived further away just so I didn't run into an issue in the middle of nowhere).

It's either after 3 days or on day 3 (I need to double check) that I'll finally be able to shower. That kind of sucks. Not liking that at all lol. And then wearing the compression vest under clothes for a while isn't going to be enjoyable in the summer either (I guess based on my initial observations I'd recommend aiming for a winter surgery if you can -- we'll see if my thoughts change as I move forward). I'll likely have to bust out some of my bigger shirts because the current athletic golf polos I wear aren't skin tight by any means, but I feel like the vest will be pretty noticeable through them and I'd prefer to avoid that.

That's really all I can think of at the moment. Only other thing is I'm going to try and contact my insurance to see if there's any chance of some help on coverage if I were to have my initial surgeon inform them that surgery is in fact necessary; maybe even just on the anesthesia or hospital costs. Anything would help and ours is set up with an HSA now anyway, so I know people can buy bandaids or anything else deemed worthy with their card; so I would think I could use that for some of those costs (again, I'll have to look into this -- I'll update on what I find out).
 
MidwestBeast

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Tomorrow is the day. Surgery is just a little over 24 hours away.

Waiting on a phone call from the pre-op nurse with any additional details on what to do/not to do tomorrow morning heading into things. If I don't hear from them by Noon, I'll be giving them a call.

Obviously won't be posting for a couple days after lol, but I'll update as soon as I can with details for anyone who has been interested in what this venture is like.
 
tyga tyga

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You should put up before and afters (if you don't mind?)

I know that would help those who are on the fence with getting the surgery. Some, are afraid of what the "after" will look like
 
MidwestBeast

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You should put up before and afters (if you don't mind?)

I know that would help those who are on the fence with getting the surgery. Some, are afraid of what the "after" will look like
I'll definitely take them. Will likely take me a while before I put them up (I wouldn't put up any afters until the healing; though I may take some during that process too).

But I'll tell you, the befores won't go up until the after portion is ready simply because I hate how much how it looks. Sad, but that's the truth of it.
 
tyga tyga

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No, I completely understand man!

The process could potentially give others the confidence to go ahead with the procedure, that's all!

Glad you're finally getting it done for yourself though.
 
MidwestBeast

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No, I completely understand man!

The process could potentially give others the confidence to go ahead with the procedure, that's all!

Glad you're finally getting it done for yourself though.
For sure, man. And that's what I was hoping to accomplish here. It gives me a chance to kind of work myself through all of this, but also will hopefully give others some more insight.

I know I did tons of googling and stuff, and it's just hard to find trust-worthy sources or people you'd necessarily believe. Hopefully those that have been around here for a while will know they can trust me and feel comfortable asking questions, too.

Sad thing is I should be able to put up a before pic right now with no issue. But mentally/emotionally, it's just too much for me. It really sucks that that's how it is, but I'm not lying to myself about it. I'm extremely self-conscious about it. And of course it's bad either way, but mine didn't even come from mis-use of gear or anything like that -- it's from stupid elevated prolactin from a pituitary issue (not that it should make a difference of the how, but it does to me -- just because not only do I hate how it looks, but i feel like any person who sees it instantly thinks "yep, he used steroids" even though it wasn't the case).
 
Gutterpump

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Question for you, did the prolactinoma cause enough of a pituitary issue that you had to start on TRT as well?

Btw, I hope the surgery goes well man. I'm sure it will.
 
Woody

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Best of luck in surgery MWB! Let us know how it goes
 
MidwestBeast

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Home recovering.

I'll post updates later tonight or tomorrow
 
MidwestBeast

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MidwestBeast

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Checked the gauze this morning and all of it was perfectly clean. So the incisions have started to heal up and that has gone a lot quicker than anticipated.

Still wearing the compression vest 24/7. I'll be able to shower tomorrow and then still wearing it non-stop for the rest of week 1 before 12 hours/day.

They prescribed me Norco for the pain, so I've been taking that as prescribed still and just feel the bruising in my chest; nothing worse. But I've also made sure not to seen myself off the meds too quickly just to make sure I don't end up in pain.
 
Johnybgood

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Checked the gauze this morning and all of it was perfectly clean. So the incisions have started to heal up and that has gone a lot quicker than anticipated.

Still wearing the compression vest 24/7. I'll be able to shower tomorrow and then still wearing it non-stop for the rest of week 1 before 12 hours/day.

They prescribed me Norco for the pain, so I've been taking that as prescribed still and just feel the bruising in my chest; nothing worse. But I've also made sure not to seen myself off the meds too quickly just to make sure I don't end up in pain.
Great to hear!!! Wishing a smooth recovery and great end result.
 
tyga tyga

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Awesome bud!
 
clk

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Subbed. Very interested in this
 
slicer89

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Im about 8 weeks out from mine, so i know what you are going through. Ill give you a little update of where I am at.

Lost about 50% of feeling in nipples, and i think its going to stay this way. My gyno started to rebound about 6 weeks in, so im on a PCT like cycle with BLR supps and its almost gone after 7 days in. I have some scar tissue right below my nipples that iv been trying to break down. You might have had otherwise but mine was cut right under the aerola and i really cant see the scars anymore unless i try.

Took about 4 weeks in until i started lifting and about 6 weeks before i was doing any chest exercises. You will notice at the beginning that it will swell when lifting so make sure to use your compression vest when you workout and something even tighter for after.

I never grabbed any before pictures unfortunately, but it was so bad that i had to wear sweatshirts for months because i was too embarrassed of the balloons on my chest. It looks great now and if i had 20 posts id post it lol.

Mine costed about $5000, wbu?
 
MidwestBeast

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Im about 8 weeks out from mine, so i know what you are going through. Ill give you a little update of where I am at.

Lost about 50% of feeling in nipples, and i think its going to stay this way. My gyno started to rebound about 6 weeks in, so im on a PCT like cycle with BLR supps and its almost gone after 7 days in. I have some scar tissue right below my nipples that iv been trying to break down. You might have had otherwise but mine was cut right under the aerola and i really cant see the scars anymore unless i try.

Took about 4 weeks in until i started lifting and about 6 weeks before i was doing any chest exercises. You will notice at the beginning that it will swell when lifting so make sure to use your compression vest when you workout and something even tighter for after.

I never grabbed any before pictures unfortunately, but it was so bad that i had to wear sweatshirts for months because i was too embarrassed of the balloons on my chest. It looks great now and if i had 20 posts id post it lol.

Mine costed about $5000, wbu?
About 5 hours from now will mark a full week from the surgery.

I didn't remove the vest (aside from opening it to swap out gauze the night of the surgery and the following day) until Friday late morning when I took my first shower. I promptly put it on right after drying off (and washing/drying it while I had showered). I took it off to shower again on Saturday afternoon and left it off while wearing a compression tank under my shirt for about 5 hours while we attended our friends' little girl's birthday party and put it back on once I got home. I did the same thing for church on Sunday for about 2.5 hours.

Yesterday, I removed it to shower and wore the compression tank under my shirt at work and it was off for about 9 hours. I'm doing the same today.

It was supposed to be after week 1 that you can go 12 hours a day on/off, but the way those straps are on the shoulders (adjustable, with velcro), there's no way to wear anything less than a sweater or sweatshirt without that part being very visible. So I'm only having it off while at work. The compression tank is obviously nothing at all like the vest, but I feel like it's better than nothing. Although I'm OCD, so I put that stupid thing back on the second I get in the door.

Between the surgery and/or the vest, my upper chest still feels kind of numb to the touch, but it's seemed to wear off as yesterday passed (which led me to believe it's the compression of that vest) and is obviously back again today following sleeping in the vest. But one thing I know for sure, my nipples aren't numb. I could feel that when I showered.

My surgeon did a pull through method via 2 incisions just below the pec on each side (so 4 tiny incisions total; about half an inch long I'd guess; maybe less) and advanced lipo-suction to get the fatty tissue around it removed. I'll get a picture to show how small they are.

There seems to be a slight bit of puffiness on the right one still, so I'm hoping that tends to go away, but I'll find out more tomorrow when I have my post-op visit. Left side looks great. I've also put on about 10 pounds over the past month and a half or so (back up to 230), so as I lean back out that will obviously help, too (as will being able to lift again and get glycogen back in there).

I appreciate you posting and adding your experience/insight. It's very helpful. I'm jonesing til when I can safely start working out again.

Unless anything changes (fingers crossed it doesn't), mine ended up at 3,500 (2,500 to my surgeon and a split of about 60/40 of 1,000 to anesthesia and the facility). Not cheap, but well worth getting it done between the pain of the lumps and sheer embarrassment (way I figure is at least a portion of that would have had to be spent on new clothing, so that's something).
 
MidwestBeast

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Had my post-op checkup today and the doc was very impressed with how the surgery went and how I was recovering. Scheduled a final follow-up for August and said in another week I could start working out, which was crazy surprising to me. I'll obviously see how it goes and it will be toe in the water as far as starting up at like 30% of what I normally do. But I'm really excited to train again and to lean back out. Won't be hard to get back to where I was just at 6 weeks ago.
 
MidwestBeast

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Played basketball yesterday afternoon for my first physical activity since the surgery.

Was insanely winded, but no pain, which was great.

I did, however, manage to catch 2 simultaneous elbows to one of my incision areas just over the ribs on a rebound and then down the court on a steal. I subbed out and checked to make sure no bleeding or anything, but it was good.

I didn't play under the basket much at all just to avoid as much contact as possible (which is hard for me).

I may go into the gym once this week, but I'll be traveling through the weekend, so I'll start my official rehab stint lifting next week.
 
MidwestBeast

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So, this was taken 12 days after surgery.

I apologize for the quality; hard to get a photo of yourself to get the scars that are located underneath the chest. And don't mind that I look oily lol; I had just got out of the shower and chest hair takes forever to get completely dried off (the only time those first 2 weeks I had that vest off was just to shower and for a bit after; I'm too lazy to have taken it off at a separate time solely to get a picture).

Anyway, it's been 3 weeks now since the surgery and the scarring is already going down a bit more even from that. At the time, the two outer scars are the more noticeable in part because of no coverage via body hair, but they also were raised slightly -- they have gone down a bit. The two inner ones are very hard to spot in that picture and are only marginally noticeable.

Anyway, I'm very happy with things so far and my wife said she notices a difference in my chest, which is great. Unfortunately, I managed to eat with far less control and mindfulness than I should have when I was unable to be physically active (you're supposed to have ice cream after surgery, right?? lol), so I managed to climb back up about 18 lbs. from where I had been at. Already down 2 and that was without effort -- so I'll be pushing to get back to where I was and I'll try to put together a side by side of the two shots before and after surgery when I'm at the same body weight.

Screenshot_2016-06-26-17-49-56.png
 

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