Wednesday, September 29, 2010


Migraines I suspect are more common than we think. One in six women and one in twelve men suffer from them. They usually begin in puberty and tend to affect people aged between 20 and 45 years of age. Now for the first time ever they have associated a gene that seems to increase the risk of migraines, This DNA variant seems to help regulate levels of glutamate which is a neurotransmitter that helps nerve cells communicate with one another. Research is looking into substances that may effect the build up of glutamate at the nerve endings. The margin has surely brightened for migraine sufferers.

Stay in touch with Dr. Robert J. Brueck for future blogs or visit his wesite at



It seems every time I turn around there's a new kid on the block, a new filler, a new laser and of course they promise the sun moon & stars. Many pharmaceuticals-makers of Restylene announced the FDA has approved their new drug Xeomin, that might be a good one for scrabble players. This is a butulinum toxin type A that has been approved to treat blepharospasm and cervical dystonia or spastic neck muscles. What's nice is that the drug does NOT require refridgeration. They are now doing clinical studies to get approved for cosmetic benefits.


Monday, September 27, 2010

Gynecomastia: Diagnosis and Treatment, by Dr. Robert Brueck MD, Fort Myers

Another in the series of blog postings by Dr. Robert J. Brueck, MD FACS, Board Certified Plastic Surgeon practicing in Fort Myers and Cape Coral, Florida

I recently read an article in a national newspaper talking about the ramifications and the seemingly increasing incidence of gynecomastia or male breast tissue. Gynecomastia can be extremely large, tender and in some cases some men may suffer from breast cancer.

I feel the biggest issue with male breast tissue is the social embarrassment and psychological harm it can do to the individual. It can be truly devastating.

What causes gynecomastia: Usually gynecomastia is triggered by a hormonal imbalance which means less male testosterone compared with the female hormone, estrogen. This imbalance can be due to natural hormonal changes, certain medications and certain health conditions. About 25% of the time it is idiopathic i.e. there is no particular cause.

Male hormones control characteristics we associate with men, such as muscle mass, body hair, etc. Female hormones usually cause female characteristics i.e. breast growth and this hormone is estrogen. It’s important to know and realize that men also produce estrogen, the small quantities produced in men help to regulate bone density, affect their moods and also sperm production.

Gynecomastia in puberty is usually due to hormonal imbalance and usually goes away in a year or two. We often see gynecomastia in obesity and in that situation the abnormal breast tissue or collection of breast tissue, usually is atty tissue. As men age, there is another peak of gynecomastia occurring around the age of 45 to 50. It’s thought that about 25% of men suffer from it.

Certain medications such as AIDS medications or some meds used to treat prostate enlargement or cancer can cause gynecomastia. Some of the more common medications associated with gynecomastia include Digoxin and Furosemide or Lasix which is a very commonly used diuretic. Also the use of anabolic steroids (seen in gym rats) used to enhance athletic performance can cause gynecomastia as well.

On examination the gynecomastia may be fatty tissue and hence we call it psuedogynecomastia or lipomastia. There is very little breast tissue. When one examines this individual the abnormal breast tissue is soft and does not have any firm grittiness to it.

Most of the time the exam reveals a combination of fatty tissue and BREAST TISSUE. The breast tissue itself can be firm and nodular. In some cases the gynecomastia tissue is located underneath the nipple areolar complex. This can cause the nipple areolar complex to increase in size and be puffy. The gynecomastia also can be asymmetrical, that is one side can be larger than the other.

HOW TO TREAT IT: Treatment varies depending on what one finds on examination. Assuming there are no offending medicines, anabolic steroids, etc then one can either accept the condition or consider getting it surgically removed. Obviously, if there is a medication that may be the underlying culprit then stopping that medication may cause the gynecomastia to go away on its own.

If the underlying breast tissue is fatty tissue only then liposuction alone may be adequate. If it is a combination of breast tissue and underlying fatty tissue then I utilize suctioning and actually direct excision.

Usually, the incision I use is centered around the nipple areolar complex. Obviously we want to create as little scarring as possible. The biggest decision is, do we need to remove excess skin? We try to do the excess skin excision, if necessary with incisions around the nipple. This way the incision can be camouflaged and be limited to the area around the nipple areolar complex. There are some examples of this on my website.

The operation usually takes one to two hours and is done as an outpatient under sedation. What this basically means is there is no pain associated with it. There is minimal discomfort post-op as well and we certainly provide the patient with pain medication to control any discomfort they may have.

I think the most important thing to do post-op is to wear a compressive vest overlying the chest area night and day to minimize swelling and keep the skin from folding. I usually recommend that an individual wears his vest for a minimum of two weeks, sometimes up to four weeks depending on the degrees of skin laxity, swelling and edema.

Sometimes, but rarely, insurance will help pay for the procedure. I have to say that the results can be amazing and, oh so gratifying, when you can give an individual his life back as a result of suffering from gynecomastia.

If you would like to learn more about plastic surgery and how it may help you with facial or body concerns, visit Dr. Brueck's website at

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Thursday, September 23, 2010


They're pesky little devils. It seems you fall asleep and a new crop arises. Very commonly kids or adults have them on their hands or extremities, scratch them off-and the auto-inoculate another part of their body. What this means is that warts are viruses-you scratch one off containing the virus and then scratch to touch another part of your body and you may soon develop a wart there. That's why it's best to treat them when they are few and far between.

What's the best treatment? Liquid nitrogen is by far the most effective. A recent study of 250 patients showed liquid nitrogen effective 49% of the time; salicylic acid 15% and doing "nothing" 8% So there you have it.

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It seems as though you can hardly pick up a paper, turn on the t.v. and not read or hear something about "obesity." I know, I for one are more aware of it- if I'm at a sporting event or walking in a mall or really any public place it really, unfortunately, stands out at you.

A new study was recently released that drew a link between obesity and a VIRUS! This virus is known as adeno virus 36. There are 50 or so adeno viruses and this particular one has the ablity to infect fat cells. In laboratory animals who's fat cells are infected with adeno 36, guess what? They gained weight. The study was done at a children's hospital in San Diego. They studied 124 children, 1/2 were in normal limits and 1/2 were obese. Of those the researchers found antibodies to adeno 36 in 19 children, 15 of those were obese. Now studies obviously need to be done.

Wednesday, September 22, 2010


The "what is it?" is Allyl methyl sulfide. Doesn't sound to appetizing-not something you would want to put on your lips yet I'm curious as to what it is. It really has been around a long long time. It is something most of us have tried and some people, me included, really like it. Yes, it's GARLIC! Not only does garlic taste good going down anyway- it also is good for us.

When we sweat and breathe the garlic smell comes out. But fret not- researchers at Ohio State University have found that having a glass of milk after eating garlic can reduce the foul breath smell by half. Whole milk is more effective then skin milk. What's best? Drinking milk with your pizza, spaghetti or whatever your favorite garlic dish is.


Sunday, September 19, 2010

Dr. Brueck MD FACS reports on skin care news

Dr. Robert J. Brueck regularly blogs about skin care and cosmetic surgery's contribution to healthy skin and youthful looks. Dr. Brueck, who practices in Fort Myers and Cape Coral, Florida, also maintains a web site featuring insights and information about plastic cosmetic surgery.


Every time I pick up a journal it seems that there is a new skincare product or regimen. “What’s the latest new craze?”

Vitamin B3 is the latest. Emerging literature seems to indicate application of topical B3 can reverse sun damage. It may not be as effective as Retin-A but it also is less irritating and easier for some patients to tolerated especially people with fair skin. It can also be used in treating acne, rosacea, actinic or sun damage, and even alopecia.

We now have the NIA24 skincare regimen which is based on this research. The results so far have been good.

So if many of you have been trying other skincare regimens and have had problems you may want to consider getting on the NIA24 regimen.

Thanks for stopping by.

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Saturday, September 11, 2010

A testimonial from a grateful gynemastia patient.

This is another blog report from Dr. Robert J. Brueck, MD FACS, Fort Myers, Florida plastic surgeon who has a web site at that discusses this and other cosmetic surgery issues.

I always am proud and happy to share with the readers of this blog letters I get that are uplifting. This one is especially rewarding. It comes from a man who suffered with the condition called gynemastia, more commonly known as "man boobs". It is a source grave discomfort for men who face humiliation, shame and derision from people who do not understand.

"Dear Dr. Brueck:

"There are really no words to express how grateful I am for what you have done for me.

For over 15 years I have suffered from the humiliation of gynemastia. I thought the extreme nature of my condition was untreatable and that I was doomed to live a life of shame and self-loathing. When I came to your office I was shown more compassion and caring than I have ever known. My whole experience was absolutely the best. I feel like a brand new person. The results of your surgical skills are simply incredible and nothing short of miraculous.

What you have done has saved my life and I would wholeheartedly recommend to anyone considering this, or any other procedure, to put themselves in the expert hands of Dr. Brueck.

You and your staff are agents of the true and divine presence in the universe. Thank you very much for all you have done." - J.P.

This letter and many others I receive testified to the fact that plastic cosmetic surgery is a source of healing for thousands of people. I am so proud to be associated with such a noble cause.

Thank you.

Thursday, September 2, 2010

Another testimonial for Dr. Brueck, Fort Myers plastic surgeon

From time to to time, Dr. Brueck gets testimonial letters that he likes to share with other patients and those considering plastic surgery. Here is one, which also will appear on Dr. Brueck's web site. Other testimonials also can be found there.

"When you look in the mirror, what do you see? For me, I saw WHO I was, but, not HOW I wanted to look. After four children, I was ready for some cosmetic changes that would make me feel more confident and comfortable in my own skin. I met two other surgeons before finally meeting Dr. Brueck. He had this warm personality that immediately made me feel calm and relaxed. I had a vision in my mind, and he somehow captured that vision and with his superb talent, he created that imagined vision into a gorgeous reality.

I had a full tummy tuck with muscle revision and a breast augmentation. My friends, family, strangers.... but, most importantly, Me, are impressed with the results. Everything looks natural. My new breasts are so perfectly placed that they look as though I was naturally blessed with a fabulous set of knock-out breasts. And the abdominoplasty... PHENOMENAL!! My abdomen has NEVER looked this good.

Dr. Brueck's artistic and sincere regard for my final outcome produced glorious results. The scar is so low and almost perfectly symmetrical, I could not have imagined it any better than this. Dr. Brueck is a talented surgeon and a man who truly wants to make the dreams of his clients a reality for all the world to see. Thank you, Dr. Brueck."

Obviously, this is one patient's experience and, while there are other similar stories on the testimonial page of Dr. Brueck's web site, this is not a guarantee that you or any other patient
will have identical results.

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