Reasonable expectations for gynecomastia surgery and abdominal liposuction? (Photo)

Hello from Istanbul! According to your pictures, there actually is some skin laxity. In cases like yours, we remove the breast tissue, decrease the fat tissue but inject some fat tissue into the upper part of the chest to prevent a saggy appearance and create a tighter, more natural look. Best of luck to you.

Certain techniques/technologies can reduce the probability of sagginess post-surgery: plaster technique (gynecomastia), Vaser/Ultrasonic liposuction, and compression garments. Proper skin assessment is a must.

Thank you for your question and for sharing your photographs! I would need to examine you to best answer your question. Gynecomastia is often an inherited condition that cannot be improved without surgery. Fortunately, the condition can be treated with liposuction. With this technique, I make a small hidden incision in the areola (the colored area around your nipple) and use a combination of liposuction techniques with very fine cannulas to recontour the chest. This combination of liposuction techniques also helps to tighten the skin and create a smooth contour. I perform gynecomastia surgery in our office's fully-accredited operating room with IV sedation administered by board-certified anesthesiologists. For patients with more skin laxity, I sometimes combine liposuction with Thermage, a non-invasive, radiofrequency (RF) treatment that is clinically proven to help smooth, tighten and contour skin and can be done at the same time as surgery or during an office visit. I recommend you meet with a fully-trained plastic surgeon to discuss your goals and treatment options.

Based on your description of the problem, your height/weight ratio and your photos you are an excellent candidate for these procedures.
It appears that you do have a bit of loose skin already on your chest and abdomen, however it is unlikely that these surgeries will impact that to a great deal. For example, I can see that your belly button is more horizontal than round, so I know that there is a bit of extra skin there. Having said, that, it does not look like you have too much extra skin to do the procedures. This is where an in person evaluation is helpful, as the skin can be examined in person and a surgeon can show you before and after photos of similar patients.
At a consultation, your past medical history will be reviewed, a physical exam will be conducted and a surgeon will let you know if you are a good candidate for the procedures, as well as give you a quote for the procedures.
The other things that will be discussed are surgical details (scar position, length of surgery etc), expected outcomes, recovery time and a good description of what recovery is like as well as risks of both procedures.
Other questions you may have may be specific to your lifestyle, such as questions about getting back to your particular line of work and your specific sports.
All the best to you,
Dr. Nancy de Kleer

Thank you for sharing your pictures! Gynecomastia is often an inherited condition that cannot be improved without surgery. Fortunately, the condition is often easily reversed with liposuction just by making a small incision under the nipple reducing the size of the breast using virtually a scarless technique. Liposuction with ultrasound and fine laser beams liquefy the fat and glandular tissue recontouring the breast around the areola and from the sides and bottom of the breasts. Because liposuction stimulates the skin to tighten, a smooth contour after fat is removed is possible. Our office also offers a treatment called Thermage. Thermage® is a safe, non-invasive, radiofrequency (RF) cosmetic procedure that’s clinically proven to help smooth, tighten and contour skin for an overall younger looking appearance. The treatment delivers natural looking results with little to no downtime, and can be done at the same time as surgery or in an office visit. Thermage® uses radiofrequency technology to heat the deep, collagen rich layers of your skin. The heat helps tighten existing collagen and stimulate the formation of new collagen, which reduces sagging, renews contours, and improves the smoothness and texture of the skin’s surface. Comfort Pulse Technology, including a vibrating handpiece delivers enhanced patient comfort. While you will see an improvement immediately, Thermage® usually takes up to 6 months to see the maximum result and this improvement is said to last approximately 18 months. Often patients repeat Thermage® more often to get additional tightening. Seek examination from a board-certified plastic surgeon familiar with these improved approaches to discuss the best options for you.

Hi, by your photos, you are a candidate for gynecomastia and Liposuction. You can have great results. Only after an in-person exam, your doctor can say if you need a Tummy Tuck too, to avoid saggy skin.- Consult a board-certified plastic surgeon in your area. Good luck!

You look to be an excellent candidate for liposuction of the chest and trunk. Excess breast tissue can usualkly be removed from an incision around the areola. The skin may have some laxity after the procedure but this is common in most 50 year old men. Your surgeon should be able to show you before and after results so you understand what to expect.

Let’s break these down as two separate procedures. To choose the right operation requires having a clear understanding of what the underlying problem is. Thinking of subcutaneous fat as being the primary issue is often simplistic, and the lack of taking all valuables into consideration often skews patients understanding of their own candidacy for various procedures.
There are three tissue variables that determine what the male chest looks like. These are skin laxity, excess subcutaneous, fat, and excess glandular breast tissue. Each of these variables can contribute and need to be assessed in order to determine what the best treatment option is. The easiest way to differentiate is to eliminate skin laxity by putting the skin and pectoralis muscle under tension. Do that by taking one arm at a time and stretching your arm behind your head like you’re scratching the top of your back. With the skin and pectoralis muscle under tension you can clearly see the outline of both subcutaneous fat and glandular tissue. It may be helpful to have someone take pictures or set up your camera Using a timer. Avoid taking pictures using mirrors. You can then slowly move your arm back down to a dependent position and while doing so observant the changes in contour of your chest. Moving your arm down does not increase subcutaneous fat or glandular tissue. It simply shows you how much skin Laxcity contributes to shape and contour.
Glandular tissue requires open, excision, which can be done with a fairly small areola incision. Most gynecomastia surgery requires open, glandular excision combined with subcutaneous fat removal through Liposuction. if preoperative exam shows that the chest develops significant fullness with the arm in a dependent position, or lifting up on the skin above your chest, significantly improve your contour then this tells you how much skin laxity is contributing to fullness of your chest. That fullness will still be there even if you remove subcutaneous, fat, and glandular tissue to some degree.
For individuals who have substantial skin Laxcity of the chest will need a chest lift, including all of the scars that come with it to get the best contour.
Making an accurate assessment, and clearly having a grasp on the three tissue variables to determine the contour of them Male chest is not always straightforward and easy. Without an accurate assessment, results will be unpredictable. A substantial number of individuals will avoid a chest lift because of the undesirable scars that go with the procedure. In the end what is appropriate for one person may not be appropriate for someone else. The decision should be based on having a clear understanding of what the underlying problem is, understanding all treatment options, and having a clear understanding of what you’re trying to achieve compared to what you’re willing to go through.
Generally, speaking patients should be prepared for a partial improvement when they have contour issues that are related to more than a single tissue variable.
It’s certainly possible to address all three with a single surgical procedure. Sometimes this requires replacing the areola as a skin graft or doing a proper chest lift. The procedure is fairly complex, and there will be a substantial difference in skill and experience, depending who you consult with.
A sufficiently competent plastic surgeon should be discussing each of the three tissue variables, and having a clear understanding of how much each one is contributing.
Regarding your abdomen, I’m going to separate the front of your abdomen from the rest of your torso.
There are four tissue variables that determine what the abdomen looks like. Three of them are pertinent to male aesthetics. Therefore variables to determine what the male abdomen looks like are abdominal skin laxity generally do to weight fluctuations or loss of skin elasticity due to age, excess subcutaneous fat, muscle separation from previous pregnancies, which only applies to women And lastly, excess visceral or intra-abdominal fat.
Men typically have a greater chance of having issues with visceral fat then women, but the condition can affect both genders.
To assess the thickness of your subcutaneous, fat layer simply press your finger against your skin until you feel the underlying muscle wall. You don’t have to press hard to feel the muscle wall. You can try doing it over your ribs to get a sense of how thick the fat layer is. The fat layer on the rest of your torso is probably fairly consistent.
If your subcutaneous fat layer is 1 inch thick then you can expect 3/4 of that to be removed with well done Liposuction.
If your abdominal wall bulges, then you have visceral fat, and this will not be reduced by having liposuction. A straight abdominal wall should create a beeline between your sternum and your pubic bone.
Based on your pictures and information included, it doesn’t look like your subcutaneous fat layer is that thick. Visceral fat is contributing significantly and weight loss is by far your best option for having a better looking abdomen.
Well done Liposuction should not create skin laxity, but already present skin laxity significantly interferes with delivering consistent quality, liposuction results.
Improvement on the rest of the torso, especially love handles is highly dependent on the presence or absence of skin laxity or loss of skinny elasticities. history of significant weight fluctuations of even 30 pounds can have cause skin laxity. Age is also not in someone’s favor in regards to the quality of skin. Men who have a history of weight fluctuations or are over the age of 50 should expect love handles to still bulge somewhat after the procedure giving a partial improvement at best. Even with the fat removed the skin can still bulge outwards especially when wearing a belt.
On a scale of 1 to 10 I would give your candidacy for abdominal liposuction at 4.5.
Your chest also has a significant skin component and this needs to be taken into consideration when setting expectations correctly. I’m not sure if the skin laxity warrants and chest lift so if you go for having a standard gynecomastia surgery, you need to have clear understandings of the inherent limitations of the procedure.
Delivering consistent quality, Liposuction and gynecomastia results is more difficult than most people realize.
Having mastered this procedure does not only mean the ability to do deliver high quality results, but also the ability to make accurate assessments and deliver predictable outcomes based on having numerous before, and after pictures of similar patients with similar body characteristics depicting exactly what your result should look like. To get the most accurate assessment and help in the process of finding the most talented provider I recommend patients have multiple in person, consultations before considering scheduling surgery.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous men who were of similar age with similar body characteristics.
Being shown a handful of pre-selected images, representing the best results of the providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider or how many of these procedures any one surgeon has actually done. It’s helpful to have pictures of your own body to use for a reference whenever comparing before and after pictures, whether at home or during in person consultations.
For a reference an experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Male Liposuction represents about 10% of cases in most practices so keep that in mind when it comes to expectations in regards to providers having sufficient numbers of before and after pictures
Comparing the result of female patients is not particularly helpful, because men or women have very different characteristics when it comes to fat distribution , and how they respond to Liposuction.
There’s no correct number of consultations needed to find the right provider. The more consultations, you have the more likely you are to find the best provider, get an accurate assessment, and start to get a sense of what these procedures can, and cannot accomplish, including variations of surgery.
As a general rule of thumb, I recommend patients consider having at least five in person, consultations before scheduling any permanent and irreversible body contouring procedures.
Patients who are less than ideal candidates for cosmetic surgery should be more careful with deciding whether to have cosmetic surgery or not, since the potential for excellent outcomes, are inherently limited, even in the hands of the best providers.
Some patients are content with having partial improvement, while others will only consider having surgery if the outcome is transformative.
It’s remarkable how different people can perceive similar outcomes.
High patient satisfaction is best achieved by having a clear understanding of what the underlying problem is combined with a clear understanding of what each procedure can, and cannot accomplish, including having a good understanding of procedure alternatives, as well as having done a sufficient job in vetting plastic surgeons, and having chosen a sufficiently talented and experience provider to help you through the process.
When in doubt, I recommend patients slow down and schedule more consultations.
I recognize that the process is time consuming and can’t be labor-intensive. You’ll be reminded every day for the rest of your life. For some people that is an important variable, and for others it isn’t all that much.
Some people are looking for just a bit of help and modest improvements are sufficient.
Good luck getting through the process.
Best,
Mats Hagstrom, MD