Question:

I am a 43 year old male and my nipples are constantly protruding. Can the nipples be removed so that they will be flat or could it be something causing the nipples to protrude?

Answer:

That can be done in the office under local anesthesia. It is just a genetic predisposition. JG 6.28.12

Question:

Hi Dr.Garcia, I am a 34 year old male. I`m trying to achieve a ripped body. I am down to a quite a low body fat percentage. My abs are mostly visible, but i have noticed there seems to be a lot of stubborn fat around the edges of my pectorals, obscuring any chest muscle definition. Is there any procedure you can recommend to get rid of this stubborn fat for a more sculpted cut chest? Thanks.

Answer:

about the only thing you could do would be liposuction. JG 3.27.12

Question:

Hi Dr. Garcia! Do you recommend massaging internal scar tissue while undergoing periodic 5fu injections for scar reduction? Also, after a few sessions, the internal mass more jagged than rounded and is tender. Is this normal? It seems that with every session, the lump feels knottier and denser. Is this the result the 5-fu working towards the core of the scar tissue? Thanks so much for your time.

Answer:

I do suggest massage for a couple of days. As the scar tissue softens it can change shape. All part of the process. JG 10.22.11

Question:

Hi Dr. Garcia. In response to an earlier inquiry regarding redness from 5fu injections, please don`t mind my mixup regarding redness and hyperpigmentation. Indeed the redness is not hyperpigmentation. It was caused from massaging the area after in injections were given therefore causing irritation. What is the classification of the redness? Is it bruising or rash? Is there anything i can take internally to help the redness fade quicker? Thanks!

Answer:

if it is redness from the skin irritation, that should clear up in a few hours after you stopped the massage, not sure why it would stil lbe red for a long time past that, migth need to see the doctor that injected you to make sure there is not an infection brewing. Best of luck. JG 4.20.10

Question:

Hi Dr. Garcia! Just received a second round of 5fu injections for internal scar tissue. This time, i notice some slight purplish bruising at some of the injection sites. Is this temporary? Also, I`m instructed not to massage the area for a week (which may have been the cause of the slowly fading hyperpigmentation after the first treatment). Do you think there may be a connection between post-injection massaging and localized redness? Thanks so much.

Answer:

yes, it is temporary. Massage will not cause hyperpigmentation, I feel, after an injection. Redness is normal as the medication is working, but redness is NOT hyperpigmentation. Hyperpigmentation is brown, not red. JG 4.13.10

Question:

Hi Doc! Would IPL be effective for treating SLOWLY fading hyperpigmentation from 5fu injections. I am unsure as to why this occurred since it was injected under the skin to reduce internal scar tissue. Maybe the 5fu irritated the tissue just below the skin? The skin surface itself is fine minus the lasting redness underneath. Thanks.

Answer:

possibly, yes. Best of luck. JG 4.8.10

Question:

Hi Dr. Garcia! Why do 5fu injections cause localized skin redness that seems to slowly fade? It`s been about 10 days, and I still have what looks like a minor rash around the injection site. My doctor was careful to inject away from the skin surface. Is this coloration of skin normal and is it to be expected every time 5fu is injected? If not, is there anyway to prevent it? How long does it take for the redness to fully fade? Thanks again!

Answer:

it is irritating to the skin, that happens more so with Kenalog though. The material needs to be injected directly into the scar tissue, not around it, the scar tissue will not absorb it. That redness can happen with further injections, it can be diluted if it is too much though. No way to predict how long it will take to fade, sorry. JG 3.29.10

Question:

Hi Dr. Garcia. Regarding 5fu injections for internal scar tissue, how long usually does it take to see any results? It`s been 5 days and the swelling went down from the initial shots, but the area is still tender and the skin is slightly red. I don`t yet notice any reduction in scar tissue mass. Would you day it`s still too early? Thanks again!

Answer:

it will start to soften some after 1-3 injections and progress from there. All depends on how hard it is to begin with. I would likely not expect to feel much difference for at least 4-6 weeks. JG 3.24.10

Question:

Hi Dr. Garcia! As per your recommendation, I went through with the 5fu injection to reduce some internal scar tissue last Friday. My only concerns are localized tenderness and slight hyperpigmentation on the skin surface. Am I worrying too much, or are these effects uncommon? Thanks again!

Answer:

all normal and will go away, best of luck. JG 3.22.10

Question:

Hi Doc! How frequent should 5fu injections be given for localized scar tissue reduction? Also, how much is typically administered per spot injection? Thanks!

Answer:

I perfrom them every 2 weeks if no kenalog is in the mixture.I administer enough to swell the scar itself. JG 3.6.10

Question:

Is 5FU safe to use on internal scar tissue from gynecomastia surgery? I have some scar tissue around the right nipple likely from trauma since the gland was more invasive on that side. It is fairly minimal and appears slightly larger than the left side of my chest. I`m certain that it`s not leftover gland since the surgeon was adamant about removing it via excision and lipo. He suggested kenalog, but it seems that 5fu is a safer and effective alternative. My concern is the possibility of kenalog leaving indentations. It`s a risk I cannot take. Supposedly 5fu does not cause atrophy to surrounding tissue. If kenalog is used to reduce scar tissue with very little (if any) surrounding fat, can it still cause indentations or is the atrophy limited to scar tissue and fatty tissue? I`m also aware that kenalog can be very tricky to inject effectively. If 5fu is a viable alternative, would the injections be administered similarly to kenalog? Thanks!

Answer:

I have used the 5FU for years with very good results and less problems than with kenalog. It can in some cases still cause skin changes even if there is no fat, yes. It is injected like the kenalog is. JG 3.5.10

Question:

Is 5FU safe to use on internal scar tissue rom gynecomastia surgery? If so, is the injection administration similar to kenalog?

Answer:

I have used it safely for years. JG 3.5.10

Question:

Hi again .. I am the mother of the 16 yr. old. I live in New YOrk state. I read a lot of your ans.. about cost ..free consultation etc. I am considering scheduling an appt with your off. If you did the surgery.. how soon before he could fly home? what kind of recovery? if not, could you refer me to someone in the Buffalo, new york area? Gracias.. mil gracias

Answer:

Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. I am sure you wil be able to fiind soemoen close to you. All the best. JG 1.12.09 http://www.surgery.org/public/findasurgeon.php.

Question:

Hi Doc. Thanks for ans my questions about my 16 son. What I mean is that the tissue behind the skin looks like fat..soft..etc. not glandular like or harder. I can see it when he wears a tshirt but he conceals it by wearing an undershirt with a button up shirt over (then it is not noticeable) Here is the debate.. do you think surgery or lipo. pics of both on the internet. The surgeon i saw said the majority of the bulge on his breast is fat.. like i said. And he said losing weight would help but I dont think it is. I worry that he will develop an eating disorder from extreme dieting and working out. how much could this cost? Please forgive me for asking more.. My heart is destroyed for my poor kid.. It kills me to see him in such distress. Thank you again and god bless

Answer:

weight loss cannot be directed to one area, that is why I do not think weight loss will likely impact it. It might be able to be removed with liposuction alone but typically I tell the patient that when I finish the liposuction, if any remains, then that hard glandular tissue needs to be cut out at the same sitting. JG 1.12.09

Question:

I notice not many questions about male breast issues. That ladies reminded me of my son, the one i posted about here with the little breast buds. You stated that the 16 year old still has 3-4 years of puberty to go??? didnt realized it lasted so long. My son who just turned 13 still has the breast buds, tho the rest of him is filling out, He still has a very athletic build tho, is about 5 4 105 lbs. I know he is self conscious of the breasts, but they are tiny, not getting any bigger but he would like them GONE. Do you think when he is full fledge man looking they will be gone? He is an athlet but doesnt work out with weights yet. Would that help, building pec muscles or is it just something he has to wait out? I havent noticed any of his peers with this problem.

Answer:

75% of the time they go away, but that means 25% of the time they do not, if he is really bothered by it, they can be removed now. There are no exercises that will mitigate the breast buds though. It happens in about 1 in every 500 boys or so. JG 1.12.09

Question:

Sorry.. I just wrote the long email.. I meant he wighs 196 and used to weigh 225 or so not 125... thanks,

Answer:

at that height the weigth is not the issue. JG 1.11.09

Question:

Hi Doctor. Here is my problem. My son is 16 and a half. He is 6`2 and weighs 196 lbs. He used to weigh about 125 lbs about a yr. ago. The problem he and I are tormented with is that he has large breasts. I have taking him to see a surgeon and his fam. doc. according to blood work there is not a hormone inbalance. The surgeon suggested he lose weight and thought if he got down to maybe 185 lbs the problem would go away. He doesnt have a social life. He hates his body..spends lots of time alone and is humiliated by this problem. From what I can see over his shirt it looks like soft jigly tissue like fat. Not hard or whatever like a female breast. His family doctor told him he would have to deal with big scars but did encourage surgery. The surgeon suggested weight loss because he felt 75% was fat and maybe 25% hard tissue. This poor kid is now dieting like a maniac.. working out.. and although he has lost weight the problem is still there. I am willing to pay for surgery or lipo.. which one is best? Do you think more weight loss will take care of the problem? My heart is broken for him. no dates, no movies, no prom this kid has nothing. I had some complication with a tummy tuck and I think he is now afraid of plastic surgery and miserable with this situation. By the way his chest area is much bigger than normal and soft jiggly like. Please doc tell me your thoughts? do you recommned, lipo, surgery, aerobic ex, dieting, or weight lifting? Please reply to this desparate mother. Thank you and have a good one. How about some hormone Therapy? When does puberty end could this be a puberty thing?

Answer:

hard to say what he needs without seeing him in person but if the skin is jiggly I think he will need some degree of skin removal and therefore scars, but it is likely worth it if he is that concerned with what is going on. I do not feel further weigth loss will do much. I do not think when he ends his puberty in 2-4 years that it will all go away either. Best of luck. JG 1.11.09

Question:

My almost 13 y/o sone, who is about 2/3 the way thru puperty, has little breast buds. He is not over weight at all, very lean and athletic body, about 5 3, 100 lbs. His pediatrician says it happens sometimes at his age, but assured him it will go away. He doesnt seem too embarrassed about it, but has asked me repeatedly if i am sure it will go away. I have 2 other boys, one younger and one grown, and have not seen this in either of them. I have to admit, it looks a little odd, almost like when a girl first starts getting breast. Will it go away? if so, when?

Answer:

it resolves in 75% of the boys by the end of puberty. JG 11.3.08

Question:

Hi again Dr. Garcia. First I wanted to thank you for answering my previous questions, it was encouraging and helpful. To follow up, I did some reading up after reading your answers. I found that the medication I am taking for my nerve pain can cause an increase in prolactin which I have learned can also cause gynecomastia. I really only have the pain and soft tissue behind one nipple so I did a test and squeezed the nipple and had a clear or somewhat milky sort of disharge from the one nipple. From what I have read I understand that this is a signal of prolactin induced gynecomastia, would that be correct? Also, in further reading, I learned of a drug called Dostinex which inhibits Prolactin and is sometimes used in treatments to counter side effects of raised Prolactin such as decreased sex drive/impotence/gynecomastia etc. Have you heard or know anything about this drug and its use for gynecomastia which seems to be induced by raised prolactin? In a study, the dose was just .5mg twice weekly. I would be interested in hearing your opinion or insight on this medication as a possibility. From what I have read it would carry less risk of side effects then using a straight anti-estrogen. I plan to bring up your advice and all of this info to my GP next week. Thanks again!

Answer:

you are correct on the prolactin causing it at times. If you have a documented elevated prolactin level then the Dostinex might be beneficial, yes. Your GP might feel more comfortable using bromocriptine though, it is used more often so docs are more familiar with it although it has a shorter half life and is not as effective as Dostinex in prolactin related issues. All the best. JG 8.6.08

Question:

Hi there Dr. Garcia, I am a male and am getting the developing of gynecomastia as a side effect from one of my medications. Unfortunately this is a medication I must take for an illness/condition, but it is quite possible that I may only need to take this medication for 6-12 months. The medication is for nerve pain (Gabapentin) but I am told of a good chance for remission. My questions to you sir are; 1. Are there ways to help cope with the pain of gynecomastia - in the breast? 2. Is it possible that I may experience an initial flare up and then the gynecomastia will dissipate once I am on the medication for some time? 3. Further to that, if that is not possible, will it keep getting worse or does it reach a thresh hold so to speak where it levels off and the pain and growth stop or slow etc. Just some background info to note, I did get gynecomastia about 7 or 8 years ago from Proscar and ended up having it remvoed by a PS (did a good job). Once you get gynecomastia, are you more sensitive to get it in the future? I may need to opt for surgery again (I am accepting that) but I am wondering if you can give any insight on how to deal with the problem while I run the course of my medication...My GP suggested a medication to help with anxiety and said there are other options if it gets too bothersome but did not elaborate. Sorry so long and thanks so much!

Answer:

Nolvadex should help with the pain and the development, also the use of Arimidex would help too. It is not unusual for a large flare up and then get better, depends on what is causing it. With Gabapentin it might slow down in formation. Once gynecomastia develops it is rare for a total remission to occur although some regression can be seen. If the medication is causing it and continued use is needed it can continue to grow, yes. The response from patient to patient is variable so there is no way to say 100%. Previous gynecomastia does not predispose one to development in the future but all of the breast tissue can never be removed without areolar distortion. Try the Nolvadex and see how it goes, best of luck. JG 8.5.08

Question:

I had gyno surgery from another local surgeon here in town about 8 months ago. My question is that I am concerned that the gyno will return? Is it possible? If so, what measures can I take to prevent it? Also I am wondering what is revision surgery all about? I am not really happy with the results. Will revision surgery take out more fat or scar tissue? Can it be done without local anestesia, on a walk in basis? By this I mean being awake and numbing the area to remove fat and scar tissue?

Answer:

since not all of the breast tissue can be removed for fear of having a depression behind the areola, you need to avoid any excess estrogens, your doctor or primary care physician can assist you there if you are concerned. Revisionary surgery varies from patient to patient and that is never the same between patients. It can involve removing more breast tissue, at times it is removing scar tissue, sometimes it is removing fatty tissue only. As to whether it can be done under local, it all depends on what needs to be done and your pain tolerance and the doctor`s preference. We at times do it under local and other times under general anesthesia. JG 7.21.08

Question:

Hi Dr. Garcia, I am 52. About 4 years ago, I had thermage to my whole face. I didnt notice any fat loss as has been reported by others. However, recently, I have dark patches on my cheeks, some are circular and well circumscribed. The areas are very slightly indented. Could this be due to loss of the collagen that thermage had stimulated my skin to produce ? It doesnt look like sun damage, because the areas arent flush witht he skin.

Answer:

I do not think it is due to the Thermage after this much time, must be some other cause. JG 7.15.08

Question:

I had liposuction and removal of hard tissue through excision for gynecomastia . It has been 3 months post op .But I can still feel some hard lump in one of my breast near aerola . Surgeon says it is induration which is common occurrence. But the lump is not showing any signs of reduction even after 3month post op . Can induration be as hard as gynecomastia tissue ? Should I be worried about that ?

Answer:

yes it can, might need some injections of kenalog to soften it, no need to worry though, it happens frequently. JG 5.28.08

Question:

hey, i lost about 100 pounds a couple years ago, but my chest has not gone away, its affected my life greatly its a nightmare having man boobs, how much does it cost to get a reduction? is there any places that do probono for this, i am very tight on money but this is ruining my life.

Answer:

I am unaware of any place doing pro bono plastic surgery at the present, as to the average fee, it varies but I would guess somewhere around $6500 or so, depending on where you live and the length of the surgery. JG 3.3.08

Question:

Dr. Garcia, How much does a breast reduction cost?

Answer:

you need to pick your surgeosn as their fees vary. JG 8.10.07

Question:

I was wondering if you perform nipple reduction surgery. I am pretty sure I dont have gynecomastia, but the size of my nipples has been a problem for me. I am 21 years old and have measured my nipples to be 30mm+ in diameter. I have never been overweight, but I have some fat on my breasts, but no hard or rubbery tissue under the nipple which I have read is a sure sign of gyno. How much would nipple reduction cost, what is the length of time for recovery, and what size can I expect my nipples to be after surgery? Thanks.

Answer:

I would really need to see you but if you are referring to an areolar reduction, which is the pigmented skin around the areola, if performed under general anesthesia it would run about $3000. No lifting more then 20 pounds for two weeks, OK to shower the next day. I normally make them about 15-20mm in diameter. JG 2.13.07

Question:

Hello Dr. Garcia, I am a 17 year old male and I have had knots under each of my nipples for about 4 years now. I am in fit condition and only weight around 120 lbs. so weight is clearly not the cause. I have been to the doctor about this before and he said it would go away after a few years. It`s been two years since. I`m worried it could be something more because I also found a small not on my right testicle, which the doctor told me was Epiditimitus. What do you think?

Answer:

the nipple issue most likely is gynecomastia and if it does not resolve it may need to be cut out, as to the testicle, epidymitis is the most common, yes. JG 11.19.06

Question:

What kind of feelings can i expect from this procedure and is this something that can cause health problems in the future...being a survivng cancer patient i have come upon this tissue problem in the last few years and i need it taken care of but money is quite the issue at the moment....what can be done

Answer:

I am sorry but I am not sure what procedure you are referring to. JG 10.27.06

Question:

I would like to get male breast reduction. I have had this since my early teens. No matter what my weight is, it will not go away. I need to lose 20-25 lbs. My question is should I lose the weight before I make an appointment or does it matter that much. Thank you.

Answer:

I think it best to be within 10 pounds of the weight you desire prior to surgery. JG 10.3.06

Question:

How long before hard knots under nipples go away after male brest lipo and tissue removal. I had that along with ab/flanks lipo in May of this year and my nipples are still tender. Is there anything that can be done to speed up the process? Thank you.

Answer:

can take up to three months in bad cases for the lumps and longer for the sensation. JG 11.07.05.

Question:

Hi Dr Garcia, I am a 26 year old male considering making a appointment for male breast reduction or to see if I need the surgery. How many male breast reductions do you perform in a year? Also do you have sample pictures to view?

Answer:

We peform about 25-30 per year. We have some pictures in the offiice we can show you too. JG 8.20.05

Question:

hello i have a problem with my upper chest a.k.a man boobs do you reccomend any exercises or any other alternatives before i think about having surgery

Answer:

unfortuantely surgery is probably the only thing that will reduce your gynecomastia. JG 8.8.05

Question:

I am a 31 year old who has lost almost 100 pounds (no surgery, just willpower & determination) but now I am wondering why when I have SO much loose skin from years of overweight. Do you provide a probono service for a very low income family? Do you have any referrals or suggestions for me if you cannot help?tjs

Answer:

I am sorry but I do not know of anyone performing those surgeries pro bono. JG 6.7.05

Question:

hey, im 18 years old and no one knows about my problem, it is embarrassing, i live in seven hills, las vegas. i am afraid to be in public with my shirt off, my nipple are very perky, i am very athletic work out all the time, and it has never gone away, almost like i have breasts, is there a way to where i can have all the perkiness taken away, this has bothered me for years. i want to have a regular adult male chest with no excess fat or perkiness, are you the doctor to go to for this, what all do you suggest? thank you 6/01/05

Answer:

There is surgery that can reduce the projection of the nipple and possibly the removal of any abnormal breast tissue below the skin that may exist. I would encourage you to schedule a confidential consultation and we can advsie you further. JG 6.6.05

Question:

I'm interested in Male Breast Reduction and wanting to ask Dr. Garcia how much does it cost? Is it depending on the size of breasts to be reduced or is there a flat rate? How long does it take to recover? I have been working out on my chest for a while but the result is not showing so good, I would like to have a nice chest, can it be done? Thank you.

Answer:

The cost is $3675 for male breast reduction. Recovery is 2 weeks of light duty, then back to normal by the end of one month. No lifting more than 20 pounds for the first 2 weeks. Removing the fat and breast tissue there should leave you with a better contour and allow your hard work in the gym to be shown off better. JG 10.14.04

Question:

Dr. Garcia – I’m a 26 year old man that is 3 years post-op from a gastric bypass done at the Fobi Clinic in Los Angeles. I’ve lost over 185lbs and am comfortable and stable now at 175. I’m interested in coming full circle by having adomnioplasty and a male breast reduction. I cannot seem to find any photos of the people my age and men that have had this procedure. do you have any examples? How successful have male pectoral implants been? I would really like to see the results so I can see if it’s worthwhile for me to proceed. Do you know any doctors that specialize in bypass reconstruction specifically in men? Do you have any experience in this area?

Answer:

I am unaware of anyone who specializes in men weight loss reconstruction. We had a patient for the procedure you describe shown last year on the Discovery Health Channel and they do replay it but I am unsure as to when. We have done quite a number of weight loss reconstructions on men here in Las Vegas as it is a popular procedure here. They will have us on again in mid-July for a woman after weight loss reconstruction. As to male pectoral muscle implants, I have been unimpressed, they look real only when the man is standing still but do not look very good upon motion. JG 6.29.04

Question:

Dr Garcia, I'm a 29 year old male who has dealt with a condition called gynecomastia since a young child. I'm very interested in a reduction procedure. I would like to get an idea of cost, and more importantly, an idea of length of recovery since my job is physical. Also, what is the length of time between your consultation and actually having the procedure done? THANKYOU S.Q. 4-23-04

Answer:

The cost will depend a great deal on how much tissue is there, as our fees are related to time. It can vary from $2000 up to $4500, depending on whether we can do it with liposucttion alone, or need to cut it out, or both. Recovery after surgery involves no lifting more than 20 lbs. for about 10-14 days after gynecomastia surgery. Usually we can get you in about 2-4 weeks after I see you in consultation. One of my nurses can see you in the near future and give you a fee quote, and that visit is free of charge. Gynecomastia is a common problem and patients feel much relieved after it is taken care of. JG 4.24.04

Question:

Dr Garcia, I had a liposuction in my breast 6 months ago, I am a male 30 years old. Since then, I have been on diet and working out, so I am starting to develope my pecs, but One side of my breast though, is growing again and I noticed a hard little ball under my nipple. My question is : after the breast reduction... can fat tissue grow back ? or maybe it is just that one side of my pecs is growing more muscle ?

Answer:

Liposuction of the chest in a male can easily remove fat, but occasionally there is nodular breast tissue present behind the nipple. Many times liposuction alone cannot remove the actual breast tissue, and what is required is to surgically cut it out. There could also be some scar tissue there which has formed causing some swelling. The development of muscle behind the nipple in a small localized spot is doubtful as the muscle is actually quite flat and wide. I would suggest going back to the doctor for an examination and a suggestion on what is best in your particular case.