Severe gynecomastia, stretch marks, and 'tummy tuck' belly. Any suggestions? (photos)

Thanks for photos.  Weight loss is tough.  To do it right, it often helps to have a professional guide you with the right program.  Once you get control of your weight (ie. stable for 6 months) within a reasonable goal, then I'd tackle the gynecomastia and abdomen with one of two approaches: 1) Aggressive liposuction to decompress fat in stage one, then return in 3 to 6 months to remove skin, or, 2) one stage gynecomastia corrective surgery combined with abdominoplasty/panniculecomty.   If you think weight loss is unrealistic or too difficult, then you could probably proceed with both surgeries understanding that your outcome will suboptimal (that is, not as good as it could be with weight loss).  Be sure to be off all cigarettes or you won't heal.

Your tummy is not ready yet for the surgery, keep on your diet plan and when you settle in a normal BMI you can discuss options with your surgeon.Notwithstanding, you are currently a real case in need of full gynecomasty mastectomy, with horizontal scar and nipple grafting to lift it up. Go ahead with it, considering the serious downside of the massive scarring mentioned.

. . . means that you are looking at excisional surgery (as opposed to liposuction) to manage these issues as best possible, which also means some extensive incisions (but usually well-worth the trade-off for much-improved shape . . . )  In my mind your abdomen may be more challenging, as you may have more intra-(inside) abdominal girth, but if mostly external, that can be managed with a fairly aggressive abdominoplasty.  I have a fair amount of experience managing severe gynecomastia, but that usually results in anchor scars that may be reasonably well-hidden with the chest hair you have.  The skin is what it is with respect to stretch marks, but if they can be incorporated into the skin to be removed, you'll lose much of them; the remaining ones will also usually look better when (ironically) put back on stretch.  A rough estimate is $8-10K for the abdomen (including OR time), $6-8K for the chest (and possibly less if combined).  Hope this was helpful!

You did not list your height or weight.  If you are actively losing weight, then I suggest you get down to the goal weight or close and then get evaluated. Your chest will likely require a skin excision procedure.

I believe your situation requires surgery, however, once completed you stand a good chance of overcoming your social anxiety issues---at age 23, it is likely these issues have already affected your psychological development. Is your weight stable? If so for how long? Are you on an medicines? Have you ever had a comprehensive medical/endocrinological evalaution?Surgery and non invasive skin reconditioning, properly performed, may be a game changer.Best of luck

Dear musa1992,

Thank you for your photo submission, comments and
concerns. Certainly to have body contour
and concerns such as you have in a young male can cause significant social
anxiety.

If you decide to seek surgical results it is important that
you have achieved a stability in your weight and weight maintenance will be an
important part of maintaining your post-operative results. It appears from your photos that breast
reduction surgery would be indicated, as well as a skin only abdominoplasty and
lipo contouring procedure for love handles and flanks.

There are several good physicians who perform this very well
in Toronto. I would recommend you seek
out the experience of Dr. Peter Bray on Avenue Road and Dr. Zel Krajden at
SpaMedica. Breast reduction surgery,
abdominal skin tightening and liposuction surgery will help with your truncal
and chest concerns and then exercise and weight maintenance to protect your
investment.

I hope this information has been of some assistance and best
of luck.

For more information please review the link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto