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Cosmetic surgery:

"I had surgery to correct it."

After Les' review of the journal article, Gerry responded:

Les Winnick wrote about gynecomastia. I am one who has had surgery to correct it.

I first had cryosurgery 8/94 then RRP, 1/96. I began use of antiandrogens without Lupron/Zoladex 12/95. I have been avoiding Lupron/Zoladex to maximize quality of life and using only antiandrogens with Proscar first Eulexin, then Casodex, now Nilandron.

Unfortunately, without preventive radiation to the breasts this treatment is very likely to cause gynecomastia. My surgery for gynecomastia was 8/96. There has been no further growth. Knowing what I know now, I would have preventive radiation. However, the surgery was easy -- in in the morning, out in the afternoon. It was necessary to wear an elastic vest for about four weeks and go in for draining of fluid once a week. A T shirt could be worn under the vest, and all could be removed to shower immediately.

I certainly would do it again rather than have female breasts.

[Ralph Anderson responded.]

I second Gerry's recommendation of radiation to prevent gynecomastia. And that comes from the experience of doing it too late.

I had radiation but it was after I had begun using estrogen. It should have been before. I had requested it earlier but got no action. By the time I arranged it on my own, it was too late.

I assume I will eventually have surgery, but that will be after my treatment has shifted to something other than estrogen. Or is that not necessary?

Gerry, were there any restrictions on what you could do after your surgery and in the following days: exercise, lifting, driving, range of movement, other? At the time of your surgery and afterward, were you still undergoing the same treatment that had brought on the gynecomastia?

Thanks for yours and for Les's input on this subject.


[Gerry replied]

Ralph A had a few more questions about surgery for gynecomastia.

I think there were some restrictions on exercise and lifting, but I don't remember what or for how long. I mostly ignored them. Driving and range of movement were no problem. It was even possible to sleep lying on my front side. I think that was probably because of numbness from cut nerves. The weekly draining which involved inserting a fairly large syringe was also painless.

Normal feeling has now returned. I wish erectile nerves healed as well.

I am still continuing the same treatment that caused the gynecomastia, antiandrogens and Proscar without Lupron/Zoladex. My PSA started to rise on 150 mg Casodex, but Nilandron brought a slight drop. PSA was 3.9 4/7/00 when Casodex was stopped. It was 3.0 10/9/00 on 150 mg Nilandron.



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