36 year old male - Recommendation for best results? (photo)

Question

Hello everyone I am a 36 year old male that is finally considering gynecomastia surgery and a tummy tuck to feel better about myself. I am currently not on any medications or any health concerns would you’ll give me some recommendations on getting the best results as well as your prices for the recommendations with your services.

J. Timothy Katzen, MD, FACS · Answer

36

Thank you for your question regarding how your best results would be obtained with plastic surgery. You only included one picture which really only depicts the back. I can only predict from the front that an abdominoplasty or tummy tuck would be a great option. Also, I can only guess from the reflection of your covered chest in the mirror that gynecomastia surgery would be best. Since you have excess skin 
on the chest, I would suggest a formal breast reduction. This would mean an incision around the areola, down the front of the breast, and underneath the breast where the breast meets the chest wall. This is in the inframammary fold. Specifically, it should be communicated to an incision that goes completely across your back. This procedure is depicted on my website and multiple youtube videos. It is called a horizontal thoracoplasty. This is certainly indicated by the picture you've attached. In terms of planning, I'd suggest you have your tummy tuck or abdominoplasty performed first. Your tummy tuck should take about 3-4 hours to complete. Plan on a 2-week recovery and then plan for your upper body about 1-2 months after. That would include gynecomastia surgery which will include breast reduction and a horizontal torsoplasty with an incision across your back to take care of excess skin and fat across your back. The horizontal torsoplasty takes approximately 2-3 hours to complete. Breast reduction would take about 3-4 hours to complete. These procedures are often combined. Please allow for a 2-week recovery. Please seek an experienced board-certified plastic surgeon when contemplating combining these procedures. Thank you for your question regarding a tummy tuck, breast reduction for gynecomastia, and a horizontal torsoplasty or back lift for excess skin of the back.

Sincerely, Dr. Katzen. 
(“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Martin Jugenburg, MD · Answer

Hello, thank you for your question. We tell our patients to get as close to your optimal results is to be at your healthiest in weight and in nutrition. You should talk to your doctor about the plastic surgery you would want and what are some realistic goals along with the risk factors that go into it. The risk factors for wound healing and infection also drastically so consider your safety first.

Kenneth Hughes, MD · Answer

Knowing your BMI is one of the first steps in your strategy to feel better about your image and your health. To reduce possible complications during and after surgery, and to get the best results, you need to consult with your PCP to join weight reduction and exercise plan. Being obese (a BMI over 35) can lead to other health issues such as heart problems, diabetes, and high blood pressure.

Daniel Barrett, MD · Answer

Dear Diligent459745,
generally speaking, you want to reach your goal weight before you consider a surgery, otherwise your results will be suboptimal if you continue to lose weight after the surgery. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Felix Omar Márquez, MD · Answer

Hi, Thanks for your question and photos. First of all, you must go to an in-person exam with a plastic surgeon in your area to see your BMI and if you are a candidate for Tummy Tuck. I recommend going to a weight-loss treatment. After that, you can have excellent results to eliminate saggy skin with Tummy Tuck. Good luck!

John A. Kotis, DO, FACS, FACOS · Answer

Hi
I have limited pictures in order to give you a proper assessment. It appears your BMI will be on the higher side based on the photo. I recommend diet and exercise regiment before seeking surgery which will optimize your results and limit your complications. I wish you the best of luck

Omer Sagir, MD · Answer

Hello Dear,
Tummy tuck surgeries must not be performed if your BMI is too high. It is too risky and doesn't provide a permenant solution for you in the long term. 
I would highly recommend you to have a gastric sleeve instead. Thanks to this surgery, you would get rid of all the extra weight on your body without going through a psychologically challenging dieting & exercising process. 
But after you lose the extra weight, your skin will get saggy since there won't be abnormal amount fat tissues to fill the skin pockets. This is the point where you should start to think about having a tummy tuck because it is the only way to get a fitter appearance considering your skin won't retract fully. 
I hope this answert was helpful to you. 
Be safe, be happy.

Jayanthy Ravindran, MS, DNB, MRCS · Answer

Although diet and workout play a major role in how your body looks, sometimes cosmetic surgery is the only ideal option when both fails. Cosmetic surgeries generally help the body in restoring the skin and muscles back to its original and natural shape and position. Two such procedures are the liposuction and the abdominoplasty which is also known as tummy tuck surgery. The main goal of a tummy tuck surgery and liposuction or to help reduce the waistline and remove excess fat in the belly area. However the procedures are quite different. 
The process of liposuction is nothing but a contouring process that is done in various parts of the body by utilising tiny and concealable incisions. Liposuction uses the process of suctioning for removing layers of subcutaneous fat from the concerned area. By subcutaneous fat we need to say that that is the layer of fat which is generally present under the second layer of the surface of the skin which is often resistant to any kind of diet or workouts. The process of liposuction is the ideal option to help get rid of that particular section of fat. However liposuction does not mend any extra muscle and skin laxity.

This is where the procedure of tummy tuck surgery comes in the picture. Tummy tucks surgery is predominantly carried out for eliminating saggy skin and tightening loose abdominal muscle, which results in our more toned physical structure. Saggy skin issues are generally not removed through any workout or diet because they are generally caused by a very weak elasticity of the tissues. So you can consult with your doctor if you should proceed with any one of these or both, but its always adviceable to lose atleast little weight before undergoing surgeries - in order to see optimum results.

Camille Cash, MD · Answer

It is best for you to first lose weight before considering a tummy tuck.  This will keep your risk lower for complications such as poor wound healing, seroma, and infection.  It also gives your surgeon the opportunity to maximize your results.  Once you have reached your goal weight, visit with a few board certified plastic surgeons near you to learn more about the tummy tuck.

Connie Hiers, MD, FACS · Answer

Liposuction of your upper back folds could help decrease the size and giving more tightening. This could be done with the gynecomastia procedure.

36 year old male - Recommendation for best results? (photo)

Answers (10)

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