Very large breasts with skin under the sides of my chest, looking for the best outcome. What's your opinion? (photos)

My starting weight in 2009 was 587. I now weigh 234. I was wearing 72" pants and now wear 40" I need to know if I should look at a lower body lift with a vertical scar (fleur de lis) or is the Extended Abdominoplasty sufficient? As you can see I have very large breasts with skin under the sides of my chest as well. Will a Gynecomastia be sufficient? I have talked to two plastic surgeons but would like another opinion. Thank you!

Doctor Answers 5

Best Outcome

Thank you for your question, and for the pictures.
Congratulations on your weight loss!  You have done the right thing by going to see multiple plastic surgeons and getting different opinions.  They have the benefit of having examined you, so I would trust their judgement over somebody who hasn't met you.  From the pictures, it does appear that an extended abdominoplasty with a vertical scar component would give you the best trunk shape.  Regarding the gynecomastia, you will either likely undergo an anchor scar pattern, or perhaps just a donut scar around the areola (may need to be repeated a couple times), but a physical exam would be necessary to make this determination.  Congratulations again, and best of luck!

-Dr. Dan Krochmal
MAE Plastic Surgery
Northbrook, IL

Chicago General Surgeon
5.0 out of 5 stars 23 reviews

Best outcome for your surgery

Healthy male patients with excess breast tissue or unwanted breast development who have no underlying breast disease.Men who desire improved physical and aesthetic appearance should have realistic expectations based on their condition and the procedure performed. You should meet with a board certified plastic surgeon to be able to get a formal diagnosis and to be able to decide on a course of treatment if necessary.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Reducing Breast Size in Men

According to official statistics, 36% of adult young men and 57% of older #adult men in the United States have this medical condition in one of the four grades. About 200,000 to 3 million cases of #gynecomastia are being reported every single year. So if you have #breast #enlargement and you feel you're an exception, please understand that 1 in 3 young adult #men and 1 in 2 older adult men are just like you and have breast enlargement. There are three types of surgical treatment options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal candidate. Weight, and more specifically body mass index (BMI), need to be considered when deciding. For instance, studies have shown that patients with BMI > 30kg/m sq (placing them in the obese category) have a higher complication rate. Therefore, it is important for patients to be as close as possible to their normal body weight prior to surgery.
 Not only will this decrease risks of complications, but will also enhance the aesthetic results. Further, normal body weight is different from one patient to another.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Fleur de lis body lift

I have treated a lot of weight loss patients over the years and wrote a few papers on just this subject.  You would have to be analyzed in person to determine which procedure would be best.  Good luck.  I like to start with the body lift first.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

S​ever gynecomasatia,be careful to choose the right gynecomastia expert.​i

Sever gynecomasatia,be careful to choose the right gynecomastia is complicated and there is a need for a very experience gynecomastia surgeon.

Mordcai Blau, MD
New York Plastic Surgeon
4.6 out of 5 stars 74 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.