The University of British Columbia, Vancouver, Canada did a study of over 400,000 men from ages 15 to 25. The study was regarding the side effects for current users of the anti-psychotic drug, Risperdal or the generic equivalent, risperidone. The results of the study showed men were 5 times more likely to develop gynecomastia than those who did not take the drug. Additionally, a study was done on one million older men who took Risperdal, and the results showed they had 69% higher chance of developing male breasts.
In 2005, The FDA required a “black-box warning” on the packaging of Risperdal. A “black-box warning” is the most stringent warning required by the FDA, a warning reserved for serious or life-threatening drug side effects. To date, the warning is only concerning the substantial risk for elderly dementia patients who are at increased risk of death by taking the anti-psychotic drug.
It is hoped that in the future there will be additional warnings such as the increase of prolactin levels that may cause gynecomastia. In the meantime, even with lawsuits continuing to be filed, Risperdal has not been recalled by the FDA or Johnson and Johnson. Risperdal is still being prescribed by doctors to treat mental health issues in children and adults.
Risperdal is an antipsychotic drug manufactured by Janssen Pharmaceuticals Inc., a subsidiary of Johnson and Johnson. Of all medications on the market, Risperdal has one of the longest histories of legal disputes due to the side effects, mainly gynecomastia, that the drug causes. At one point, it was the most prescribed antipsychotic in the United States. What a travesty for boys and men suffering from mental illness to have the addition of developing male breasts.
The first case to go to trial regarding the consequences of the drug was in September of 2012. The trial ended in a settlement on the first day for an undisclosed amount. For more information on Risperdal and it side effects, see the blog for August 14, 2015.
Since the first court case, five more were settled in 2012, and Johnson and Johnson is now facing hundreds more lawsuits. It is believed that the drug raises prolactin levels and blocks dopamine, resulting in the possible development of gynecomastia.
If you Google Risperdal lawsuits, you will see multiple offers from different law firms offering to represent men who have had gynecomastia develop due to Risperdal. Some law firms claim there is a settlement in progress that may pay out large amounts per claimant.
Back in May of 2014, meetings were started to petition for Risperdal Multidistrict Litigation (MDL). An MDL is not a class action suit but is for individual claims.
In a class action suit, one lump sum would be awarded if a settlement is agreed upon. Then the award would be divided equally between all plaintiffs no matter what their degree of injury.
For multidistrict litigation (MDL) all of the pending claims are represented in one courtroom and heard by one judge. Then each plaintiff would be fighting his own claim and can negotiate an individual settlement with their Risperdal attorney.
Johnson and Johnson has already paid 2.2 billion dollars to the Department of Justice when, Janssen a subsidiary of J&J, pleaded guilty to misbranding the antipsychotic drug.
To date, there are more than 1300 cases pending in the Philadelphia Court of Common Pleas. So far there have been three bellwether trials. The purpose of bellwether trials is to help gauge how juries may respond to testimony that may influence future negotiations and settlements.
In February, the first bellwether case was all over the news as it settled for 2.5 million dollars. The plaintiff was a 20 year old man who started taking the drug when he was 8 years old for treatment of autism. The second case went in favor of the defendant as there was insufficient evidence that the plaintiff’s gynecomastia was caused by Risperdal. The third case just recently settled in favor of the plaintiff for an undisclosed amount.
The statute of limitations varies greatly from state to state. If you believe you have been a victim of this drug, it may be in your best interest to see a Board Certified Plastic Surgeon who specializes in gynecomastia, and perhaps a Risperdal attorney.
Most surgeons take before and after pictures of their patients. Board Certified Plastic Surgeons receive special training in photography due to the importance of this documentation which assists them in surgical planning. Beyond surgical planning, the photographs are a useful tool for surgeons to show prospective patients the quality of their work. Many patients appreciate being able to see their before pictures to compare them to their surgical result.
For a man with gynecomastia, also known as man boobs, searching for a gynecomastia specialist can be daunting. There are many aspects for the man to consider. First, he needs to be sure the surgeon is Board Certified in Plastic Surgery. Second check out where the surgery is to be performed, hospital or surgical center and find out if it is accredited. If it is an accredited surgery center, he should ask for a tour and note if it is organized and clean.
During the consultation, the gynecomastia patient needs to ask lots of questions. Find out how many male breast reduction surgeries are performed per year. Ask the surgeon what method of surgery he or she plans. Unless the man has “pseudo-gynecomastia” (only fat and no excess breast tissue), the combination of liposuction and surgical excision is necessary. Liposuction alone will leave breast tissue behind, necessitating a secondary surgery to remove the breast tissue. In order to remember all your questions, it is advised to bring a list.
Possibly one of the most important aspects to help a man determine the expertise of the gynecomastia surgeon is in the viewing of the surgeons before and after surgery pictures of actual patients.
In viewing the before and after pictures, there are a few things to note that will help determine the accuracy of what you are looking at. There should be different angles taken of each patient; front view, oblique and side view. Almost anything can be made to look good from just one angle. The background should be consistent, a blank wall or a black drape works well. The person needs to be placed in the frame in the same position, with arms down at their sides, or in the same position, for both before and after surgery. In addition, color saturation and lighting needs to be the same or as close as possible, for easier comparison.
Bearing all these things in mind, it is understandable how difficult it can be for a man to choose the best top plastic cosmetic gynecomastia surgeon he can find. The effort will be well worth it, to be able to avoid revision surgery. The single most common cause for the need of a secondary surgery is where the initial surgeon mistakenly thinks that liposuction alone will remove the male breasts of a man with “true gynecomastia”. As mentioned earlier, liposuction will work for the man that has “pseudo-gynecomastia” which is caused by fat alone.
If you are disappointed with the results of your original male breast reduction surgery and have lost confidence with your Plastic Surgeon, first discuss it with your surgeon and see what suggestions he or she may have. Then get a second opinion from a Board Certified Plastic Surgeon who specializes in gynecomastia surgery. If he or she agrees with your original surgeon you are probably on the right track and the revision may cost you little or nothing.
However, if the original surgery left you with a major defect such as a crater deformity or the surgeon only did liposuction and the other surgeon confirmed that you should have had excision of breast tissue as well, you may need to choose a new surgeon with more experience for a revision. In picking a new surgeon be sure the office staff makes you feel comfortable, you will be relying on them for information and support. If they are not friendly or you sense the tension in the office, go elsewhere!
Needing revision surgery can be more expensive than the original surgery, as now the surgeon has to deal with scar tissue, and the retraction of the skin may have been compromised.
