In cases where gynecomastia has been caused by Invega usage, some cases may improve through exercise and diet. However, in many cases the abnormal breast tissue will remain, even if the patient stops taking Invega Sustenna. When tissue growth is permanent, only surgery will be able to undo the damage caused by paliperidone. Unfortunately, because gynecomastia is not life-threatening, most health insurances will not cover corrective surgery—even when gynecomastia causes severe emotional and social trauma.