Male Breast Reduction with Loose/Excess Skin

[dextermorgan]

Hi Doc,

Was previously obese at 105kg. Now is at my desired weight of 71kg. That's a good amount of weight lost and I feel so much healthier. However, this result in the problem of loose/excess skin. I am going to have an abdominoplasty for sure to get rid of some of the skin and also my stretch marks around the tummy. My breasts still have fats and also loose/excess skin hence also looking for male breasts reduction. I was wondering whether it is uncommon for patients to do both type of surgeries at the same time? And also, how much excess skin and stretch marks can be removed from the breasts as I am guessing an open incision should work in the same principle as an abdominoplasty, or am I wrong? The stretch marks on my breasts are located on the sides nearer to the armpit region.

Thanks for answering my doubts.

Regards,
Dex

[DrBermant]

Hi Doc,

Was previously obese at 105kg. Now is at my desired weight of 71kg. That's a good amount of weight lost and I feel so much healthier. However, this result in the problem of loose/excess skin. I am going to have an abdominoplasty for sure to get rid of some of the skin and also my stretch marks around the tummy. My breasts still have fats and also loose/excess skin hence also looking for male breasts reduction. I was wondering whether it is uncommon for patients to do both type of surgeries at the same time? And also, how much excess skin and stretch marks can be removed from the breasts as I am guessing an open incision should work in the same principle as an abdominoplasty, or am I wrong? The stretch marks on my breasts are located on the sides nearer to the armpit region.

Thanks for answering my doubts.

Regards,
Dex

Congratulations on your weight loss!  Does it not feel much better with that weight off?  34kg = 75 pounds is an amazing amount of tissue.

After Major Weight Loss skin and supporting tissues retract only so much leaving sagging and drooping.  These are usually global factors affecting most regions of the body.  For men, the sagging chest is often the biggest concern.  However, there are often issues of the stomach, thighs, buttocks, arms, and more.  While a Tummy Tuck Abdominoplasty can help with the front, a Lower Body Lift helps deal with the stomach, thighs, and buttock sagging. 

Combining the operations in one setting increases risks. It becomes a very long surgery. Safe amounts of tumescent solution require that lower amounts be used for chest and tumescent tummy tuck, meaning patients just do not have the same comfort and recovery as those for who I can use my full strength tumescent.

Check out the amazing comfort of my Tumescent Tummy Tuck Surgery. Most of my patients tell me that just plain Tylenol is enough for their comfort after this extensive surgery. That is just remarkable, but it happens in patient, after patient.

My tummy tuck patients tend to use their upper body / arms to get about. My Chest Lift patients use their stomach muscles to get out of bed. Knock out both sets and discomfort after surgery escalates and patients tend to stay in bed increasing risks of clots in legs.

I prefer to stage the lower surgery first and then let the skin equilibrate. Then perform the chest lift. Check out the recovery and comfort of my separate sculptures and then compare that to surgeons' combination operations. Those doctors tend to not show the early after surgery photos nor discuss pain medication needs.

Low Nipples Do Not Look Good on the Male Chest. Unless this excess tissue is removed, the excess skin can contribute to a contour problem and fold. You can see early results after surgery that addresses the skin problem on my website. 

Excess Skin of the Male Chest with Gynecomastia comes in various degrees.  Here are my Standard Pictures for Evaluating Extra Skin on the Male Chest.

Weight loss and surgical sculpture is a series of compromises. What suites any one individual will vary.  Ideal sequence that I recommend my patients:

• Get to a weight you are comfortable living with.
• Let the skin adjust as much as it will. It can take from 6 to 18 months for skin equilibration after a gastric bypass and major weight loss.
• Consider Tightening Lower Tissues First. There is little sense to lift the chest and then have a tummy tuck, lower the chest result, requiring a revision chest lift.
• Then Address the Chest.
• Use No Surgery Body Shaping Garments as emotional support not to rush the process.

The difference between skin reduction on the chest and stomach, is that the lower tummy tuck scar is well hidden in modest clothing. The chest scars remain visiable and minimizing these scars is the essence of the craft for this region.

For some patients, my small incision skin reduction chest lift is an option.  This eliminates the unnatural very obvious unnatural vertical scar.  For smaller problems, I have evolved my Internal Lift Male Mastopexy Surgery that has even smaller scars.  My internal lift is not suitable when the excess skin is a major contributing factor for the deformity.  A Male Donut Mastopexy when pushed too far will leave a star burst deformity that detracts from the result. That is why picking your surgeon carefully can be so important.

Yes, scars are a compromise.  We need some place to remove the excess skin.  The shorter the scars, the less skin that is removed. 

Options are best explored during an evaluation.

Hope this helps,

Michael Bermant, MD
Learn More About Male Mastopexy Chest Lift for Sagging Tissues

[Dr. Elliot Jacobs]

Lax skin after major weight loss is very common.  The stretch marks that you describe are part of having gained considerable amounts of weight.  Unfortunately, not all stretch marks can be removed with surgery (there is no other treatment for them) -- it all depends on where they are located.

For sure, surgery to tighten up your chest skin, elevate the nipples and remove any lingering excess tissue can be done.  It will probably require more incisions than the typical gyne operation. The resultant scars will be a trade-off for a tighter, trimmer new shape.  This type of surgery generally runs about 2 - 2 1/2 hours.  If you then include a tummy tuck, to tighten the lax skin of the lower abdomen, you are looking at an additional 2 1/2 hours.  That makes it a major operation --- and the recovery will be longer as well.

Recommend you consult with an experienced gyne surgeon who will discuss the pros and cons of combined versus individual surgery.

In any case, congrats on your weight loss -- it is the beginning of a new life for you!

Dr Jacobs

[Miguel Delgado MD]

Congratulation on the weight loss. You should share how you accomplished this with gynecomastia talk

A tummytuck is a great procedure with a high patient satisfaction rate.  If you can get past the incision , you will be very happy.

The procedures can be done at the same time if you are in good health and your plastic surgeon thinks its OK.

The skin excision in the chest usually does not excise tissue or stretch marks in the armpit. Usually more towards the bottom half of the chest.

To my way of thinking the incisions on the chest is a major issue and a topic for discussion all your life.  Many times it can not be avoided but many times it can depending on many factors.  I have not performed skin excision for more than 5 years. i try to avoid this at all cost.  the technique is more involved and sometimes a 2 stage procedure. The first stage is fat and gland excision, a internal and external lift, and possible a crescent of skin excised from the superior areola.  This works very well in many cases.  In 15-20% of men who want tighter skin a donut of skin can be excised from around the areola.  The skin excision technique is somewhat of a goal standard for weight loss patients.  It is 1 stage, cost less, and 1 healing period.

This type of case is the most difficult for gynecomastia surgeons.  Send photos and we can further discuss your case.

Miguel Delgado,MD
www.gynecomastiaspecialist.com