Am I a good candidate for gynecomastia surgery? (Photo)

Question

I’m 29 6’4 and weigh223 lbs I lost 140lb it the past two years and have been unable to lose the flab on my chest. I have had the extra fat on my chest since middle school and feel surgery is the only option at this point. Really want to feel comfortable in my own skin.

Stanley Okoro, MD · Answer

Thanks for your question and the photo you provided. Congrats on your weight loss. I can appreciate the residual fat on your chest. I would first opt to have liposuction of your chest combined with skin tightening, like Bodytite. This will allow for minimal scarring. You will need post-op skin tightening maintenance with Morpheus 8. Good luck, make sure you consult with a board certified plastic surgeon

James M. Economides, MD, FACS · Answer

From your photos you appear to have excess fatty tissue. This is best treated with liposuction. If there is a gland present (only able to evaluate on examination), this can be surgically excised as well.

Ronald Schuster, MD · Answer

Congrats on your weight loss. It looks like you have mild gyno which is probably due to residual breast gland. However you also have some skin looseness. Sometimes the skin won’t shrink back on it’s own and it might be necessary to remove some. In mild cases this can be done with a peri areolar skin excision which leaves a scar completely around the Arellano but generally heals very well. You need an exam by an experienced gyno surgeon for the best advise. Good luck.

Kenneth Hughes, MD · Answer

Skype or in-office consult would be necessary for evaluation of a gynecomastia diagnosis. Though the conventional teaching has been that liposuction cannot remove breast tissue, I have found that I can remove the breast tissue with liposuction alone. This allows for small segmental reduction of the breast to produce the best contour possible and avoid over resection, cratering, and contour deformities. This also provides for much less scarring and potential poor scarring concerns.

Tim Neavin, MD · Answer

Thank you for the photo.  Congratulations on the weight loss.  Sometimes when people lose a lot of weight the skin gets somewhat saggy.  In situations like this I recommend Vaser liposuction with or without glandular excision -- depending on the problem.  I would also implement serial compression wraps to shrink wrap the tissue.  There is a reasonably good chance that you will get good tightening which could obviate any need for skin excision.  However, I would need to evaluate you in person to see what type of elasticity the skin has.

Daniel Barrett, MD · Answer

Dear Adventurous296168,
it is hard to tell for sure without an examination. Based on your photo, it looks like you might have gynecomastia. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Leland Webb, MD · Answer

First off, great work on losing the weight that you were able to lose. Yes, you would be a great candidate for this procedure. You may require combination of both Liposuction and direct excision. Based on physical examination, however, some people are candidates for Liposuction alone. This has the opportunity to greatly improve the contours of your chest. I think that given the fact that you have very little droop of the breasts, you may have a fantastic result. Make sure to discuss your goals with a board-certified plastic surgeon. We are happy to help in any way we can.

Libby Copeland-Halperin, MD · Answer

Thank you for sharing your photos and for your question and congratulations on your weight loss! It is difficult to say without examining you. Many men suffer from prominent breast tissue, a condition known as gynecomastia. There are many causes of gynecomastia, including hormonal, genetic, and medications. Depending on the underlying cause, gynecomastia can often be treated with liposuction. I use a combination of liposuction techniques and use fine cannulas inserted through a small incision hidden in your areola (to avoid tell-tale scars on your chest). Following surgery you will need to wear a compression garment. I perform this technique in my fully-accredited operating room under IV sedation administered by a board-certified anesthesiologist as an outpatient procedure. I recommend you speak with a fully-trained plastic surgeon to see if you would be a good candidate for this procedure.

Karthik Ram, MRCS, DNB · Answer

You have gland and loose skin from the weight loss, If this is really bothering you mentally, then you should go for the surgical correction.

Yes you are a candidate for surgical correction.

Mats Hagstrom, MD (license on probation) · Answer

Successful weight loss after morbid obesity creates skin laxity and this makes traditional gynecomastia surgery without some type of skin resection difficult.

If no glandular tissue needs to be removed then a chest lift can be done but if glandular tissue needs to be removed at the same time the procedure becomes technically difficult in order to avoid losing blood supply to the nipple areolar complex.

Skin laxity is one reason patients fail to get the results they hoped for from standard gynecomastia surgery which typically only treats subcutaneous fat and glandular tissue.

Most people with that type of Weight loss have enough skin laxity to interfere with the outcome of the procedure.

Different plastic surgeons will have different views and may recommend different options on how to fix this.

I recommend having multiple in person consultations with local board-certified plastic surgeons who seem to have a good track record for gynecomastia surgery.

During consultations ask each provider to show their entire collection of before and after pictures to get an idea of what their best results, average results and less than results look like as well as some idea of how many of these procedures they’ve actually performed.

Good luck,

Mats Hagstrom MD

Am I a good candidate for gynecomastia surgery? (Photo)

Answers (11)

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