Q: Dr. Eppley, I am looking for an experienced surgeon to preform gynecomastia surgery. I have hard tissue build up under the nipples caused from weight lifting supplements. I have a muscular body but I am self conscious about taking my shirt off and people staring at my nipples.
A: Supplement-induced gynecomastia is an increasingly common type of gynecomastia that I see. The patient type is very typical having a fairly lean and more athletic type body with the localized development of hard nodules underneath and around the nipples. It is a very glandular-type restricted mainly to under and around the areolas. While it may feel small, it can be quite surprising as to the actual size of the masses when they are removed. (often being 2 to 3X bigger than what they feel like) Because of the firm tissue quality, these areolar gynecomastias are best removed through a lower areolar incision. Peripheral liposuction is rarely needed and direct excision of all hard tissue back to normal soft fatty tissue is done. Drains may or may not be used depending on the size of the excision. A chest compression wrap is important should be worn for up to two weeks after surgery. It would be important to avoid strenuous chest exercises/lifting for 3 to 4 weeks after surgery to prevent a fluid build-up which can convert to scar tissue creating a partial return of a mass effect.
Dr. Barry Eppley