Gynocomastia Treatment by Dr. Crisler

[kelkel]

Guys, thought I'd post this here in case it helps someone. Dr. Crisler, if you're not familiar, is arguably the leading TRT doctor in the country. He posted this earlier today:


"As many know, I have been working for several years to develop the best techniques for treating unattractive and troubling gynocomastia (breast tissue development) in men. Due to the nature of my medical practice, many of my patients present suffering this embarrassing condition, which erupts from a wide variety of causes. We can find significant relief in new cases through pharmacologic (using medicines and/or supplements) therapy—perhaps merely to halt further growth-- but if the condition has existed for any amount of time, often we must rely upon the surgical approach.

Additionally, many men suffer a combination of actual mammary (breast gland) tissue, along with fat deposition, adding to the unappealing appearance; this is known as lipomastia or pseudogynocomastia. As it turns out, it is precisely appreciation for the balance between the two different types of tissue which leaves previous gynocomastia removal techniques obsolete.

In working up the gynocomastia/lipomastia patient, the first step is to take a comprehensive Medical History; for many medical etiologies can produce male breast tissue enlargement. Thus the development of what--at first--seems like a purely aesthetic problem may actually signal a much more ominous, previously hidden, medical condition. And we must keep in mind a small percentage of all breast cancers actually occur in men.

We also draw a detailed battery of laboratory tests, to look for estrogen (yes, males have female sex hormones, too) excess, or just imbalances between the various forms of estrogen in our bodies (using state-of-the-art 24 hour urinary testing). Other hormones—by deficiency or excess-- can cause gynocomastia as well. And, of course, the condition is heavily associated with hypogonadism (“Low T”); the detriments to health and happiness it causes being what originally brought the patient to my front door.

We also explore the patient’s diet and supplement choices. Amazingly, numerous foods, alcohol and other drugs (prescription and recreational), highly recommended supplements, and even skin care products can result in breast tissue overgrowth in males of all ages. Again, the appearance of “man boobs” is just the tips (ahem) of the iceberg for other health risks, due to the continuous assault on the male body by various estrogen-like substances.

Now, let’s discuss the traditional surgical approach.

First, it requires general anesthesia, and all that entails. Additionally, it always leaves a more-or-less noticeable scar around the areola (nipple).

Mechanically, the strategy of lifting up the nipple, and digging down into the breast in order to scoop out excess tissue can leave much to be desired. Unless exactly the right amount of tissue is removed, the nipple may be left in an unbalanced position, or even collapse toward the chest wall. Any remaining mammary gland tissue is then left to proliferate once again—especially if the treating physician is not also well versed in Interventional Endocrinology. That is because the original cause of the gyno may still be in effect.

And there are men who, because of the shape of their particular gyno/lipomastia, simply cannot be helped by the traditional surgical technique. The shape of their particular tissue does not lend itself to a vertical approach. We frequently see them at my office.

Now come the liposuction-based techniques, based upon a horizontal approach.
When the tissue is addressed via the horizontal approach--through a small, easily concealed “nick” in the skin at the lateral pectoral line (up near the arm pit)—any and all unwanted tissues may be removed. The physician can thus easily access whatever is there; from the lateral pectoral line to the sternum, and clavicle (collar bone) down to the inferior pectoral line.

I originally began surgically removing gyno using the traditional BodySculpting technique, where tumescent anesthesia (the word “tumescent” means ”slightly swollen”) fluid is pumped in, both numbing and voluminizing the entire space. We found this technique works very well for lipomastia cases, but frequently leaves much to be desired for those lean individuals whose issue consists almost entirely of mammary tissue (especially bodybuilders). The voluminization with tumescent anesthesia so inflates the compartment, the actual glandular tissue becomes more difficult to palpate, and therefore successfully draw out through the inserted cannula. The bodybuilders like how “ripped” their chests become, but a small mound of gyno could still remain.

We had to figure out a way to first sufficiently numb the area, AND break up the tissue for extraction, but without adding so much volume from the tumescent anesthesia fluid the glandular tissue becomes obscured. If you cannot clearly feel it--you cannot remove it.

After much thought, following the experience of performing numerous gyno procedures, I began employing a combination of transdermal anesthesia along with many small localized injections of small volume, in a pattern dictated by the shape, and volume, of the particular individual’s gyno/lipomastia. This allows me to target the actual glandular tissue, from a horizontal approach, while working remotely from the lateral pectoral line (so the scar is hidden). Pre-procedure physical examination predicts the range of light vacuum pressures, and even customized fluid mixtures, we will use along the way. We often use as many as three different cannula (the metal tube inserted through the skin to suck out unwanted tissue) sizes as well.

Several patients have reported they experienced absolutely no pain whatsoever during the procedure. Sometimes the patient even falls asleep (no doubt aided by the oral medications we offer them beforehand). There’s an old saying in surgery: “a snoring patient is a happy patient.”

We would also note we can employ the new technique to target the actual glandular tissue, then introduce the tumescent anesthesia traditional to the BodySculpting technique for larger fatty deposits of significant lipomastia.
Recovery from the procedure is simple, and without complication. We insist the patient remain in town overnight—that’s just common sense-- but then is free to travel home the next day.

If the patient also needs prescription hormonal therapy, we can work that in, too. Of note, we are currently developing several Over-the-Counter (OTC) supplements which will help stop, even shrink gyno in those who are just now developing it; as well as for those who have already had the procedure, in order to rebalance their hormones.

My new technique is quick (we are in and out of the procedure room in about an hour), quite painless, a fraction of the cost of other procedures, and produces a very satisfying result.

Then it’s back outside, shirtless, once again!

Please call 517.485-4424 or email us at [email protected] to schedule a phone consultation with Dr. Crisler to discuss this revolutionary procedure."

[cjr579]

Thats a pretty cool read. I would like to give him a call and learn more about it. Anybody had this procedure done?