Hello Old Goat 1985, Thank you for your question regarding undergoing a belt lipectomy and simultaneous gynecomastia surgery. Thank you for your history. Congratulations on your massive weight loss over 200 pounds. Great job! The answer to your relatively simple question has many factors. First, consult with a plastic surgeon who specializes in reconstructive plastic surgery after massive weight loss. Not all plastic surgeons perform these procedures on a routine basis. Most plastic surgeons specializing in reconstructive plastic surgery after massive weight loss can combine the belt lipectomy and the gynecomastia surgery in one surgical setting. Combining these surgeries depends on the skill set of your chosen plastic surgeon. Some plastic surgeons are not comfortable performing both procedures at the same time; likewise, some plastic surgeons who specialize in reconstructive plastic surgery after massive weight loss have created a team of anesthesiologists, surgery techs, physician assistants, and nurses to create an efficient, comprehensive operating team, which can perform the belt lipectomy and gynecomastia surgery simultaneously. If you are healthy, don’t smoke, have a stable weight, and your plastic surgeon feels comfortable performing these procedures, you can undergo these combined procedures. However, if you are unhealthy, smoke, have uncontrolled medical conditions, and your weight is unstable, you may not be a great candidate for these procedures. I would procede with the plastic surgeon who you feel more comfortable with. Good luck. I hope this helps to answer your question about whether you can undergo a belt, lipectomy, and simultaneous gynecomastia surgery. I hope I have answered your question regarding combining the belt lipectomy and gynecomastia surgery. If you have any more questions regarding gynecomastia surgery, male breast reduction surgery, liposuction for gynecomastia or male breast reduction after weight loss, contact an experienced plastic surgeon. Since these are big procedures, please seek an experienced, board-certified plastic surgeon with significant experience performing the belt lipectomy and gynecomastia surgery simultaneously. Do your research. Ensure they have performed at least 100 torsoplasty surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced torsoplasty plastic surgeon in your neighborhood, consider traveling out of state. Sincerely, Dr. Katzen, MD, MBA, FICS, FACS. (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, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)