What is the Preferred Scarring Option for Severe Gynecomastia and Preferred Way to Move Nipples As Part of This Surgery?

There are many different approaches to gynecomastia treatment associated with massive weight loss.  While more typical correction with relatively normal skin involves removing only the underlying glandular tissue and fat, if present, your massive weight loss (congratulations) obligates some reduction of the excess skin and usually repositioning of the nipple/areola.

The goals are minimizing the scar length and visibility, preserving circulation and sensation to the nipple/areola and proper positioning of the nipple areola.

All of the approaches you mentioned are good choices.  You should consult with a plastic surgeon to decide which is best for you.

      Gynecomastia with a loose skin envelope can involve removal of skin from the inframammary fold and transposition of the nipple areola complex while attached to a pedicle.  This provides for a more normal looking areola than with a skin graft as pigmentation changes can occur.  You will not need a lollipop as you do not have female breasts, and you do not want to improve the projection of the breasts.  You just need to find an expert who can easily execute this plan and answer all of your questions.  Kenneth Hughes, MD Los Angeles, CA

Depending on the amount of breast tissue, fat and skin excess a plan for surgery is made. With young elastic skin smaller incisions and excisions are possible. A semi-circular peri-areolar incision for minimal excess tissue and minimal excess skin. A full peri-areolar for more significant excess breast tissue and minimal to moderate excess skin. And a infra-mammary fold incision as well as a transposition of the nipple areolar complex on a pedical or a breast mound to its new position. If there is massive weight lose and very lose skin with excess in the lateral part of the breast a breast reduction with a anchor incision maybe needed.

 

Good luck!