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What is the difference ???

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What is the difference ???
« on: July 07, 2011, 04:54:08 PM »
Brownie points to anyone that can help me with this question...

Pubertal Gynecomastia, from what I've read/heard, is commonly remedied over the course of a few years with no treatment; Steroid-Induced Gyno, on the other hand, once developed becomes a permanent fixture that only excision can be-rid of... Why, in that case, when both forms of onset occur due to hormonal imbalance (whether consciously induced a with drug; or induced by puberty), does Steroid-Induced Gyno differ to Pubertal in regards to recovery: over a course of 2 to 3 years shouldn't both forms be just as likely to resolve without surgical intervention ?  Why does Pubertal Gyno resolve; why does Steroid Induced Gyno not resolve ?

Linkback: https://www.gynecomastia.org/smf/index.php?topic=23644.0


Offline Litlriki

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Re: What is the difference ???
« Reply #1 on: July 20, 2011, 07:21:22 AM »
The gynecomastia occurring in adolescence resolves in 95% of patients who develop it.  The gynecomastia that occurs as a result of steroid use does resolve in some cases, usually if it's mild and related to only one cycle.  Typically, however, steroid users cause repeated stimulation of the tissue, which induces fibrosis, which doesn't go away.  I'm not aware of any comparison of the tissue removed looking at idiopathic adolescent gynecomastia versus steroid-induced gynecomastia, but the character is grossly very different in most cases.  The steroid-induced tissue is very tough, dense, fibrous tissue.  This can be the case in the gynecomastia of puberty, but more often, that tissue is of a more mixed fibro-fatty variety. 

The differences may be related to the degree and duration of stimulation, and perhaps an endocrinologist could address that.

I'm not sure if this answers your question.

Rick Silverman
Dr. Silverman, M.D.
Cosmetic and Reconstructive Plastic Surgery
29 Crafts Street
Suite 370
Newton, MA 02458

Certified by the American Board of Plastic Surgery

Re: What is the difference ???
« Reply #2 on: July 26, 2011, 02:06:23 PM »
Great question, I like your logic. when I was young we were interested in some of the receptors ie estrogen and progesterone  in patients with gynecomastia so we examined them extensively in the lab. To make a long story short its complicated ,there are multiple factors at work and we do not fully understand everything . The bottom line is the clinical observations are what you mentioned in your post.
Jay M. Pensler,M.D.
680 North Lake Shore Drive
suite 1125
Chicago,Illinois 60611
(312) 642-7777


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