Gynecomastia surgery/chest lift + lower body lift for fit 26 year old man. Which first?

Hi JH5150, Thank you for your questions regarding gynecomastia surgery and 360 circumferential lower body lift. Thank you for your history. Due to your significant weight loss of 100 pounds, you have excess chest scan. This will require a formal male breast reduction. Typically, after massive weight loss, the male chest requires an incision around the areola and in the inframammary fold. The inframammary fold is where the breast meets the chest. There is also another type of incision made from male breast reduction. This involves an incision from the armpit down the side of chest. An elliptical area of skin and fat is removed. The problem with this type of surgery is that the nipple is pulled to the side. Since the nipple is pulled to the side, an incision is made around the areola and the areola is then moved to the center of the chest. This is called a lateral, vertical male breast reduction. The benefit of this type of incision is that the incision is hidden.  When your arms are at your side this lateral incision cannot be seen.  Since you were considering a 360 circumferential lower body lift, I would suggest you have the 360 circumferential lower body lift performed first.  During the 360 circumferential lower body lift, the abdominal muscles are tightened and the abdominal wall skin and fat are pulled down. The problem is that during the 360 circumferential lower body lift, the breast fold (inframammary fold) is also pulled down. Therefore, on male and female patients, I recommend having the 360 circumferential lower body lift performed BEFORE any breast surgery. Patients must realize if they have their breast surgery performed before the 360 circumferential body lift, they may require revision of their breast surgery. Therefore, if you can wait, please have your 360 circumferential body lift performed first and your male breast reduction surgery performed second. Another alternative is to have both the 360 circumferential lower body lift and the male breast reduction performed at the same time. For these combined procedures, it is imperative you find a board-certified plastic surgeon who is experienced in these types of procedures in patients after massive weight loss. Good luck! If you have any other questions regarding the 360 circumferential lower body lift or male breast reduction surgery for gynecomastia, please contact my office. Sincerely, Dr. Katzen.  

This is an interesting question that you pose and different plastic surgeons can give very good reasons for doing either first. However, my advice to most patients deciding between the timing of two desired procedures is to have the one that bothers you most be performed first. Life can be unpredictable and so tackling the one that bothers you the most may lead you to have a different opinion on the second surgery afterwards.

I think you could have the surgery in order though it might make a little more sense to do the abdominal surgery first. Whatever loose skin remains on the lower chest after the abbdominoplasty could be addressed during the chest surgery. It is also true that the IMF can be pulled downward by the abdominoplasty. Good luck.

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.
#gynecomastia #malebreastreduction

Hi, thanks for your question and photos. Having performed many, many body contouring procedures after weight loss I see no problem with you choosing to have your gynaecomastia surgery performed prior to your bodylift. If you need significant skin reductions as part of your gynaecomastia correction it would be suggested that your surgeon "anchors" the natural creases under your chest to the underlying chest wall to further reduce the chance of these scars descending in the future. Whilst I would certainly not advocate an upper torso lift being performed at the same time as a lower (waistline) bodylift, it is certainly sometimes possible to perform a gymaecomastia correction at the same time as a bodylift if that was your desire. These decisions would be discussed during the consultation with your Specialist Plastic Surgeon. You'll be in good hands. 

Staging body contouring after weight loss typically involves performing multiple procedures in phases, usually starting with the abdomen (abdominoplasty) and then addressing other areas like the arms, thighs, and breasts over a period of several months, allowing adequate healing time between each surgery to optimize results and minimize risks. Key points about staging body contouring after weight loss: Consult with a plastic surgeon:A qualified plastic surgeon will assess your needs and develop a customized plan based on the amount of excess skin, areas of concern, and your overall health. Wait for weight stability:Before considering any procedures, ensure your weight has stabilized to avoid complications from further weight fluctuations. Typical staging sequence: Stage 1: Abdominoplasty (tummy tuck) Stage 2: Breast lift or reduction, arm lift Stage 3: Thigh lift, buttock lift Optional later stage: Face and neck lift Reasons to stage procedures: Healing time: Each procedure requires time for proper wound healing, which can be compromised if multiple large areas are operated on at once. Anesthesia considerations: Staging procedures allows for smaller doses of anesthesia per surgery, which can be safer for patients. Psychological impact: Gradual improvements can be psychologically beneficial for patients. Important factors to consider: Recovery time:Plan your schedule around the expected recovery time for each procedure, including downtime for swelling and bruising. Scar management:Discuss scar revision options with your surgeon to minimize the appearance of scars. Cost:Be aware of the potential total cost of multiple procedures when planning your staging.

When deciding between gynecomastia surgery (chest lift) and a lower body lift for a fit 26-year-old man, several factors should be considered, including the patient's specific goals, body composition, recovery time, and the plastic surgeon's recommendations.
Recommendations
1. First Procedure: Many plastic surgeons may recommend starting with gynecomastia surgery first. This can allow the patient to see immediate results in the chest area, which may boost confidence and motivation before undergoing a more extensive procedure like a lower body lift.
2. Patient Goals: Consider what concerns you want to address first. If the focus is on chest appearance, gynecomastia surgery would be the logical choice. If the overall body contour is a higher priority, then a lower body lift might be preferred.
3. Surgeon's Input: Consulting with a board-certified plastic surgeon who specializes in both procedures can provide recommendations based on the individual’s body and goals.
Ultimately, the decision should be made collaboratively between you and your plastic surgeon, taking into account your priorities, recovery time, and desired outcomes.

Without seeing you in person, hard to be certain, but I typically tell body contouring patients to start with the issue that bothers them most. If that is your chest then yes, have the gynecomastia surgery first. If your surgeon disagrees, you may want to get a second in person opinion. Best of luck.

The gynecomastia surgery can be done first,and then the body lift afterword could even full the skin down and improve the chest further.