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Genuine symptoms directly attributable to B12 overdose are poorly documented and exceptionally rare

Less typical but more grave dangers are enduring hormone imbalance, testicular suppression, or metabolic shifts that linger after ceasing therapy

The loss of bone mass can be overcome by estrogen add-back/hormone replacement therapy (Surrey, 2010) but this must be balanced to avoid estrogen action upon lesion survival and potential recurrence of disease and its symptomology

Surgery provides the most significant long-term volume restoration and can address volume loss and redundant skin for a more fully contoured treatment