How many surgeries will i need?

[ziggynj24]

My apologies if this is the wrong place in the forum to post the following question about types of surgical procedures:

I am a 35 year old obese man with severe (mostly pseudo) gynecomastia.  I am considering surgery but have a question about the types of treatments for gyne.

My gyne is severe enough that I know I have excess skin that must be removed for me to have anything resembling a male chest (liposuction and a compression vest alone will not be enough).  A few years ago I had a consultation and the doctor (Dr. Baxt from Baxt Cosmedical) told me that he would have to do two surgeries; one liposuction and then (once I have healed) another surgery to sculpt the skin.  Obviously this is going to be more expensive than if I took care of it all in one shot.

So my question is: Does anyone know if this two operation deal is typical for someone with severe gyne?  I mean is it possible and better (financially and physically) to just have one combined operation of liposuction and skin contour? Any experience in this area?  By the way, when I say severe gyne I mean I've got more than a handful in each.

Thanks for any help/insight!

Elliott

[Curiousone89]

My advice : Lose the weight and then worry about surgery.

I mean if it is mostly pseudo gyne then your problem is not to do with glands. Then again you might not even know this because maybe you could not feel it.

Therefore, I strongly advise for you to start losing weight, and if you don't have the money and planning to save up now, this would be excellent for you.

Start saving whilst you lose the weight, once you hit the optimum, just stop, see how much money you have, go for another consultation to ensure NO gland is present, and then proceed to do your surgery.

I don't really see a point for obese men to go after the surgery, a lot of PS's strongly reccomend that you lose the weight first.

In the end however, it's your money, that's just my advice.

[ziggynj24]

Thanks for the response.  That wasn't actually my question but thanks anyways.  I won't spend the time debating the issue out here (since I've already posted on it somewhere else for that) but I appreciate your advice.  I know there are benefits to loosing the weight first--as there are benefits to getting the surgery now.  Every fatty on this site will have to weigh those options for themselves.  And to fatties reading this, please weigh those options..I believe neither decision is the absolute right one (each situation is different).

Still, the question remains, how many surgeries? Anyone?

Elliott

[kingboob]

I mean that question is impossible to answer really...... only a surgeon will know for sure.

I was overweight, lost the weight and still had very extreme gyne which was a combination of fat/gland and lots of stretched excess skin.

I had surgery and to be honest the first operation got things nicely flattened out but not beach worthy, and I have needed a touch up and i will be having one more to get things perfect (hopefully)......... but that is for an extreme case and my surgeon gave me the score right from day 1 and the revision I have had was free of charge.

Unfortunately I know that most people are having to pay twice for a revision or further skin tightening in your case.  The problem is that if you try and get it done all in one go the results may not be as good and you could end up with bigger scars than absolutely necessary...... by doing it in two stages the surgeon can remove the fat and then let the skin shrink back naturally - go back in and use smaller incisions to remove any excess.

I was also lead to believe that doing lipo and skin excision at the same time can compromise the blood flow to the skin meaning higher risk of things not healing properly.....maybe one of the doctors here can comment on that??

[ziggynj24]

Thanks so much; that was really very helpful.  I think if I could find a doctor that would do revisions for free I'd be quite happy taking as many surgeries as necessary.  I know I have a super severe case and one surgery will not get me perfect but I am just trying to get as much info as possible before I walk into the office.  I wouldn't be surprised if most doctors were to tell me to do multiple operations (especially if I have to pay for each) but I will also bring these questions to my consultations.

If you have been happy with your doc, kingboob, and he/she is in or near the tri-state area could you let me know who and where they are?

thanks gain for the insight!

[Dr. Elliot Jacobs]

Obese men with gyne, like normal weight men with gyne, would like to have one operation and be done with it.  Unfortunately, it is impossible to do so when the patient is obese.

Having one operation when you are at max weight would be a herculean feat -- a massive procedure involving a double mastectomy, re-location of the nipples and removal of excess skin probably 3/4 around your trunk.  It would take many hours of surgery and anesthesia.  Add in the possibility of infection (higher in the obese or in lengthy surgery) and you have potential trouble.  And frequently you will need touch up procedures to make things as good as possible.  These are not "revisions."

Many obese men would like to just go to sleep and wake up with a normal, flat and contoured chest.  That is why most responsible surgeons will recommend extensive weight loss prior to surgery.  They can then do a much better job of re-contouring you.

An alternative approach is to perform the best possible removal of excess fat and gland tissue without skin removal.  Then, at a second stage, once the skin has tightened somewhat, another operation can be performed to remove remaining excess skin and position the nipple appropriate.  This is the two-stage approach previously described -- and it works.  And the second stage would not be a "revision" either but rather a planned, two operation approach to a problem.

Bottom line:  there are no easy answers for an obese man with gyne.  Very best recommendation is to lose a significant amount of weight first, and then tighten up the skin and chest with surgery.  Unfortunately, most obese men do not want to hear this -- they want the easy way out.

Dr Jacobs

[ziggynj24]

Dr., thank you for the thorough explanation; that all makes a lot of sense and really is quite helpful in understanding the procedure. I have already been to a few consultations (a few years ago) and that just about coincides with what I have been told (by at least one other doctor). 

[kingboob]

I would also keep in mind that weight loss will greatly improve things but in an extreme case (such as mine) you may still end up needing more than 1 surgery, especially if you have stretched skin and the nipples need moving upwards to the correct location.

[kadri1711]

whats the average cost for the treatment in ruppes

[ziggynj24]

King,

Thanks.  I know for sure that I will need my nipples to be moved.  I have stretched skin that I already know will not tighten up. I have already lost about 70 pounds and the extra loose skin around my chest has not tightened; it just wrinkles and/or sags.  

If I need two or more surgeries then so be it; I just like to be informed of options and such.  

King, if you have the time I'd love to ask you a couple of questions about your experience.

Thanks again!