Follow up - What's the right procedure to use to remove excess fat and contour sagging skin? (Photo)

This is a follow up to yesterday's question. I hope the photos attached this time. I lost weight and need fat removed from my chest. Not sure if there is anything glandular to excise. I don't want to just remove the fat and be left with sagging skin. Which procedure can help tighten the skin or contour my chest to look more natural? Please help, I feel so good after losing all this weight but can't bear to look at myself shirtless. I am adding photos. I hope they attach this time

Doctor Answers 8

Surgical Options That Treat Gynecomastia

There are three types of surgical treatment options available that treat gynecomastia. The doctor will recommend the one that is best suited to each individual case. The excision technique is used on cases of #gynecomastia where excess skin and glandular breast tissue must be removed and the areola or nipple needs reduction and repositioning to create a natural looking appearance. The incision patterns are determined by the specific condition of the patient. The doctor will recommend this procedure which combines the liposuction technique and excision technique to create a natural look. Patients are given specific instructions for the recovery period. 

Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Best Gynecomastia Procedure

Hi allied12,

Thank you for the post and the photos. You have asymmetric gynecomastia with one side being larger and the nipple being lower than the other side. Without examining you it is difficult to tell how much your skin will retract. In my experience, this type of gynecomastia requires both liposuction and glandular excision. I prefer to stage borderline cases to see how much skin retraction they get so as to not commit them to any excess scars unnecessarily. However, without examining you it is difficult to advise any more specifically. I strongly recommend that you be evaluated by an experienced gynecomastia surgeon.


Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 44 reviews

Better chest

good photos, you would get a nice improvement with lipo and breast tissue excision, with possible minor nipple lift. exam would certainly be helpful. glandular tissue could be evaluated at that time. it will be better with surgery.

James E. Leake, MD
Marietta Plastic Surgeon
5.0 out of 5 stars 19 reviews

Gland excision plus chest lipo

Great photos.  Very helpful.  Liposuction alone won't do the trick.  You will need actual breast removal (glandular excision) with chest wall liposuction.  You're a great candidate actually, and will have a wonderful result.  No extended incisions  are needed.  Just around areola and near armpit for liposuction cannulas.  Be sure to have this done with someone who does a lot of gynecomastia cases. Re-dos are more difficult because of scarring and can be more expensive.  

Tim Neavin, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 42 reviews

Male chest and excess skin

Excess skin is best removed sugically. At this present time, there are not great skin tightening devices that improve the skin adequately.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Gynecomastia Surgery

You most likely are a candidate to remove the breast tissue/fat and excess skin. Removal of the breast/tissue alone will not give a satisfactory result. Best wishes

George C. Peck, Jr, MD
West Orange Plastic Surgeon
4.8 out of 5 stars 22 reviews

Remove the fat and be left with sagging skin.

To remove the fat and fix the sagging  skin you need to find an experienced gynecomastia surgeon.This can be done .you also have to be realistic.It is not only the procedure but the right surgeon is crucial for the results.Good luck.

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

Gynecomastia with skin excess

In my opinion you would benefit from removal of the excess fat and / or glandular tissue and, possible skin reduction via a periareolar incision. The degree of skin excess and laxity will be best appreciated by the doctor examining and treating you, of course. 
The first step in the procedure is to remove the excess volume - via either liposuction alone or in combination with direct glandular excision - depending on the effectiveness of liposuction alone. There will be some residual skin laxity - how much depends on your age, how overweight you had been and your overall skin elasticity. It appears that removing the excess skin via a periareolar incision (dougnut) should be enough to give you the chest shape you desire. I hope this opinion helps.
James P. Anthony, M.D., FACS

James Anthony, MD
San Francisco Plastic Surgeon
4.2 out of 5 stars 10 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.