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Old 05-11-2012, 08:52 AM
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Default Gynocomastia-Male Breast Development.

Gynocomastia-Male Breast Development.

By: Bruce J. Nadler M.D.

Several years ago my answering service called to tell me the number of obscene telephone calls that were coming through on my line alarmed them. They went on to explain that the calls all started on normally but then all of these young men started to use foul language. They couldn't believe the number of different people doing this. I thought for a moment and then asked if the term they heard was "bitch tits." "Yes that is exactly what they say" was the reply.

With a big smile I explained to them that these were just patients expressing a medical condition. Gynecomastia, bitch tits or "the bodybuilder's tumor" all mean the same thing, the embarrassing development of male breasts.


Gynecomastia

The treatment of gynecomastia has become a specific interest of mine due to all the bodybuilders I treat. I have long ago set the world's record in performing these surgeries and have lectured to other surgeons on my techniques.

It is a problem that has existed through antiquity. Ancient hieroglyphics show the condition on several of the Pharaohs. It is not all that uncommon. The Navy did a study during World War II and classified one quarter of their recruits as having excessive breast tissue.

Causes

The condition can occur naturally or as a side effect of anabolic steroids and other medications. It has also been implicated with the excessive use of marijuana.

The use of anabolic steroids is especially implicated. Of course not all steroids will cause it, only the ones that aromatize. Anadrol, Sustanon and Dianabol are especially known causes. Some others are weaker stimulators and are dose related.

When gynecomastia occurs naturally, it is a slower process and usually consists of both glandular and fatty tissue. Anabolic steroid induces gynecomastia occurs much more rapidly and is usually a sheet of pure glandular tissue. Of course there is a range between these extremes

When the body senses too much testosterone or a testosterone like substance, it tries to reduce the level by a process called aromitization. This converts the testosterone to estradiol, an estrogen like substance. All men have some glandular tissue. If there is also genetic receptor sensitivity, the increased estradiol level will stimulate this tissue to grow.

Symptoms

It is first noticed as some sensitivity in the nipple area often going on to real discomfort. As the tissue further develops, the area will swell and extend laterally under the arm. The condition can run the range from a mass under the nipple with perhaps some coning to fully developed breasts.

It is most noticeable when you least want it to be. If the weather is cold, everything tightens up. But in the warm weather, when you want to take your shirt off, it all pouts forward and is noticeable.

I've lost track of the number of my patients who continuously pinched themselves or used ice cube and cold water to keep things from being too noticeable. Estrogen blockers like Nolvadex or Arimidex can prevent the occurrence but only surgery can cure it.

Surgery

The surgery consists of a combination of liposuction and direct glandular excision through a small incision at the nipple border. Beware of any surgeon who claims to be able to treat it with liposuction alone. I have had to operate on many patients who have had this previous surgery elsewhere.

Liposuction merely removes the fatty component and after the swelling subsides, you merely have a smaller version of what was there before.

I have also seen patients scarred across the entire chest and others who have had parts of their pectoral muscles removed.

It is done under general anesthesia and lasts about 2 hours. Liposuction is first done to remove the fatty component allowing the glandular tissue to condense. A small incision is then made at the lower nipple border.

The glandular tissue is then carefully removed tracing the extension under the arm. Too many inexperienced surgeons fail to do this creating a crater in the middle of the chest. A small amount of glandular tissue is left just behind the nipple to prevent collapse and indentation.

Often suction drains are used for the first few post-operative days to prevent fluid collection is the pocket previously occupied by the tissue. I do all the suturing with dissolving, buried sutures to minimize scarring and avoid that railroad track look. A compression vest is worn for several weeks to control the skin shrinkage.

Post Surgery Health

It is very important to be off any anabolic cycle for at least 6 weeks prior to the surgery. Anabolic steroid side effects such as slowing of blood clotting and increased blood pressure add to the possibility of surgical complications. In addition altered liver chemistry due to some anabolics can add to the risk of anesthesia.

Low impact aerobic activity can resume in a week. Light weight training can resume in 3 weeks with the exception of chest and back. Chest and back can start lightly at 4 weeks and full routines can be resumed at 6 weeks.

It is my greatest pleasure when the patients can tell me they can happily walk around with their shirts off.

For more information I can be contacted at 1-800-445-0505 or through my web site at Bruce J. Nadler M.D. Aesthetic Plastic Surgery.

Bruce J. Nadler M.D.
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Old 02-04-2014, 02:56 AM
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i have a small lump under left nipple not sure if its from tren or test but either way what can i do before it gets worse and will arimidex reduce the size its a little bigger than a pea
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Old 02-06-2014, 06:20 AM
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Letro is your best bet

Letrozole is the chemical name of Novartis selective third generation aromatase inhibitor (AI), a drug that works by blocking the aromatase enzyme responsible for the production of estrogen.

In clinical use, Letrozole is primarily administered to halt the progression of breast cancer in women. It is generally used as part of an aggressive treatment in post-menopausal women, to fight and reverse the spread of breast cancer after other treatments (such as Tamoxifen therapy) has failed. Its probably the most efficient product on the market for this purpose (5). Letrozole is very similar in both structure and action to its AI predecessor Arimidex.

In athletics and bodybuilding, it is used as an ancillary compound within anabolic steroid cycles for its estrogen reducing properties, and has the additional benefit of modestly increasing testosterone levels. Many anabolic steroids aromatize (convert to estrogen via the aromatase enzyme), a process that is responsible for many of the undesirable side effects which accompany anabolic steroid use such as acne, gynecomastia, water-retention, etc.

Letrozole also does quite a few things that would be of interest to both bodybuilders and athletes. Firstly, it has been shown to reduce estrogen levels by 98% or greater (1). In at least one documented incident, Letrozole reduced test subject estrogen to undetectable levels, while increasing LH, FSH and SHBG (4). For the bodybuilder, less estrogen in the body means less chance of estrogen-related side effects. This makes Letrozole an appropriate choice for even the heaviest bulking or cutting cycles, including those which incorporate harsher androgens. Also, if you are a competitive bodybuilder, Letrozole is a must have product for contest preparation as no other ancillary compound supports the coveted dry and tight appearance quite as well.

An effective dose of Letrozole is .25 to .5mg/day. I use .25mgs/day, but be forewarned, if you go over this amount it can kill your sex drive. Also worth noting is Letrozoles substantial estrogen rebound effect that occurs after discontinuation. Maximum inhibition of the aromatase enzyme has been cited at doses as low as 100 mcg. (2)

Its effects on serum lipids including cholesterol, both HDL and LDL are, in the words of one researcher: "inconsistent." However, you could certainly suffer an impaired lipid profile and immune system if estrogen levels remain too low for long periods of time.

As previously mentioned, Letrozole can be used to raise LH and FSH, these are hormones which signal your testes to produce more testosterone. (6) These properties mean that Letrozole can be used for post-cycle therapy (PCT), and I have successfully used it for this purpose. However, for various reasons, Tamoxifen is a better PCT choice.

How good is Letrozole when compared with Aromasin (Exemestane) and Arimidex (Anastrozole), its primary rivals? Letrozole is 10-20x more potent than Anastrozole, and about as potent (but with a slightly different mechanism) as Exemestane. It also long-lasting. Letrozole has a whopping 2-4 day half-life, and youll need to take Letrozole for approximately 60 days (with wild variance of 2-6 weeks) to achieve a steady blood plasma level (8).

Those are impressive numbers, but heres one of the most interesting things about Letrozole:

It may reduce/eliminate/reverse existing gynecomastia!

In a study conducted on mice (and yes, I know its not perfect), gyno-like changes in the mammary gland were totally destroyed! Heres a direct quote from that study:

Our results also indicate aromatase overexpression-induced changes in mammary glands can be abrogated [destroyed] with very low concentrations of the aromatase inhibitor, letrozole.(7)

In addition, both I and a friend successfully used Letrozole to eliminate our gyno while both using 2.5mgs/day, tapering down to .25mgs/day, and then finally off. The gyno never returned for either of us.

Based on its availability and cost (when you consider the fact that .25mgs/day is more than enough protection from estrogen-related sides on most cycles), not to mention its overall utility for a variety of functions (destroying gyno, preventing estrogenic sides, and for PCT), Id say that this stuff is pretty great.
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