Looking for advice on best approach for my gynecomastia. (Photo)

I lost a total of just over 125lbs naturally (322lbs to 195lbs) a few years back. I'm very active (running, weight lifting, etc.) and I'm moving forward with tummy tuck/gyno surgeries. I have gotten several quotes and I'm trying to decide what the best options are for my chest. Would Removing skin/tissue around nipples be enough or are horizontal scars on each breast and a free nipple graft needed? Also, Would a vertical scar be needed for my tummy tuck? 1 surgeon recommended this. Thanks!

Doctor Answers 5

About the Gynecomastia Surgical Techniques with a Tummy Tuck

It is not uncommon to combine a tummy tuck with male breast reduction. There are three types of surgical treatment options available to treat gynecomastia. The excision technique is used on cases of #gynecomastia where excess skin and glandular breast tissue must be removed and the areola or nipple needs reduction and repositioning to create a natural looking appearance. Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.

The incision patterns are determined by the specific condition of the patient. The doctor will recommend this procedure which combines the liposuction technique and excision technique to create a natural look. Patients are given specific instructions for the recovery period. 

Lastly, it is crucial you select a plastic surgeon who is #board-certified and has a great deal of experience with male breast #reduction. Plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your procedure. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

TT and Gynecomastia

Congrats on your weight loss! You certainly have done a nice job of tightening and toning your physique. Judging from your photos, your breasts would do the best with a transverse breast crease scar and free nipple graft . . . a periareolar lift may not do it to your satisfaction. Regarding your abdomen, I would start with a standard tummy tuck, as your upper abdomen does not have a lot of redundant skin. Of course, much of the final recommendations would require an exam.

Joel Patrick Maier, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 29 reviews

Massive weight loss consequences

I believe that your chest and abdomen could safely improved at the same operative setting.  Your nipple falls below the inferior edge of your pectoralis major muscle and will need to be repositioned while the excess breast skin and tissue are removed.  You have excess skin extending into your axilla and I would likely recommend excision of skin along the inferior edge of your pectoralis major and a free nipple graft, making sure that the nipple is placed low and lateral, as this looks better on a muscular man, like yourself.  By the way, great job on your physical transformation.  I believe that you could avoid the vertical scar on your tummy skin excision, especially if the chest excision allows some upward pull of the upper abdominal skin excess.

John Dean, MD
Baton Rouge Plastic Surgeon
4.3 out of 5 stars 18 reviews

Surgery after massive weight loss

Surgery after massive weight loss needs to be staged. Though your pictures do not show the entire body, but seems to have excess skin all around.When combining surgery in different parts of the body, need to consider the magnitude of the surgery, safety issue. and incisions should not pull on each other ( Vecrors of pull on the scars).
The abdomen, need analysis of the vertical and horizontal excess. That determines if you need a vertical scar or not, and what you desire.
 The back needs to be assessed and determine if a circumferential lift with buttock lift is needed.
The chest, needs to evaluate the excess on the breast area and the lateral chest and upper back. Breast can excise the excess skin and put the scar in the inframammary line and do a free nipple graft. The lateral chest and back scar can be a continuation of the inframammary incision of the breast continued all the way to the back.
Make a good medical decision and plan not a financial decision. The cheapest is not necessarly the best

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews


Congratulations on the weight loss. You have a lot of excess skin which does not appear to have good elasticity. Your case is not simple.While it is possible to remove the excess breast tissue it is unlikely than your skin will contract to the point where significant skin excess is not present. You will need skin excised from your chest.Similarly for your stomach it appears the two potential options are a body lift with a 360 degree incision  with or without a vertical incision.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.