Lose weight prior to surgery?

[Plarkin]

My weight fluctuates, and 90 percent of the time I am 168-181. I am now 176, with 25% body fat (unfortunately), a few pounds (and a lot of fat) over my ideal with a bit of a stomach roll I would like to get rid of that doesn't go away unless I am under 168. I can get as low as 160-162 or as high as 203-205.

What should I get my weight at on surgery day, I have about two and a half months. As low as possible? What I expect to average at post-surgery? Forget pounds and worry about body fat?

I am 5'10"and when I get under 168, it looks like I am a rail with small boobs; fat is not evident anywhere else, even though my body fat percentage might be as high as 21-22% at that weight. (A lack of muscle is throwing things off, I suspect.)

[PSC0002]

I've heard a lot of conflicting stories on this subject.   I assumed that loosing a significant amount of weight prior to surgery would be necessary, but when I asked my PS, he said "if you want to.... just don't go bench pressing and get a big chest".   I don't know his reasoning by telling me I didn't have to, but I had a nearly fist size gland removed, so I don't really know if he knew that or what. 

Long story short, I maybe lost 10lbs prior to surgery.  Feel like I have excellent results.  Maybe skin shrinkage would have been aided by a little natural decrease in size prior to surgery, but I just don't know.  In my personal experience my weight didn't amount to a hill of beans with my boob size.   

However, I will tell you that seeing myself without boobs does make my belly look bigger than I thought it really was!  That and my belly pushes up my vest.

Hope this helps

[DrBermant]

My weight fluctuates, and 90 percent of the time I am 168-181. I am now 176, with 25% body fat (unfortunately), a few pounds (and a lot of fat) over my ideal with a bit of a stomach roll I would like to get rid of that doesn't go away unless I am under 168. I can get as low as 160-162 or as high as 203-205.

What should I get my weight at on surgery day, I have about two and a half months. As low as possible? What I expect to average at post-surgery? Forget pounds and worry about body fat?

I am 5'10"and when I get under 168, it looks like I am a rail with small boobs; fat is not evident anywhere else, even though my body fat percentage might be as high as 21-22% at that weight. (A lack of muscle is throwing things off, I suspect.)

I advise my patients to get to a weight / body fat percentage they are comfortable with before considering surgery.  A BMI Calculator does not differentiate between fat, muscle, and bone.  Body Fat Calculators can help with the fat percentage and are better at helping with the fat component.

For those with too much body fat, Weight Loss Before Gynecomastia Surgery can help with the fat, but not the gland.  However, you cannot pick where your fat comes from.

Plastic Surgery is not a good jump start tool for weight loss.  I have seen disasters from patients from other doctors with deformities from significant weight loss after their surgery.  Men tend to put fat on first in the belly and chest bands.  We tend to take of those areas last.  Early surgery and depending on weight loss to predictably change the body is a nasty gamble.  No Surgery Body Shaping Garments are a better temporizing choice.

As a surgical sculptor, I view weight loss as a coarse tool and my plastic surgery as a refinement tool.  I prefer to use the coarse tool first, and then my sculpture for refinement.

For those having compromise surgery before (or without) weight loss, try to check out before and after pictures from many different angles.  Plastic Surgery is not an alternative to losing weight.  A fat person will still look like a fat person, just one with smaller breasts.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[Plarkin]

I've heard a lot of conflicting stories on this subject.   I assumed that loosing a significant amount of weight prior to surgery would be necessary, but when I asked my PS, he said "if you want to.... just don't go bench pressing and get a big chest".   I don't know his reasoning by telling me I didn't have to, but I had a nearly fist size gland removed, so I don't really know if he knew that or what. 

Long story short, I maybe lost 10lbs prior to surgery.  Feel like I have excellent results.  Maybe skin shrinkage would have been aided by a little natural decrease in size prior to surgery, but I just don't know.  In my personal experience my weight didn't amount to a hill of beans with my boob size.   

However, I will tell you that seeing myself without boobs does make my belly look bigger than I thought it really was!  That and my belly pushes up my vest.

Hope this helps

Jeeze, a fist size gland! Just one? How was it removed? Nipple? Under the arm?

[DrBermant]

I've heard a lot of conflicting stories on this subject.   I assumed that loosing a significant amount of weight prior to surgery would be necessary, but when I asked my PS, he said "if you want to.... just don't go bench pressing and get a big chest".   I don't know his reasoning by telling me I didn't have to, but I had a nearly fist size gland removed, so I don't really know if he knew that or what. 

Long story short, I maybe lost 10lbs prior to surgery.  Feel like I have excellent results.  Maybe skin shrinkage would have been aided by a little natural decrease in size prior to surgery, but I just don't know.  In my personal experience my weight didn't amount to a hill of beans with my boob size.   

However, I will tell you that seeing myself without boobs does make my belly look bigger than I thought it really was!  That and my belly pushes up my vest.

Hope this helps

Jeeze, a fist size gland! Just one? How was it removed? Nipple? Under the arm?

You can see very large Glands of Gynecomastia that I have removed from a tiny areola edge incision.  Use the navigation panel from the slide show to view the different sizes from different problems.  You can see Photos During Gland Removal here. 

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[PSC0002]

Jeeze, a fist size gland! Just one? How was it removed? Nipple? Under the arm?

Yep.  I don't have any pics yet, but maybe I can get them from him on next consult.  There were two glands - both about half the size of a fist.  (Make a fist, forward of first joints - that's about the size)  I'm guessing 3" wide, 2 1/2" thick.  They were both removed from the nipple incision.  (from 10 o'clock to 6 o'clock)  Have some drain holes under both arms. 

[Plarkin]

Damn, that sounds like a lot of gland. Who did the work? My guy doesn't use drains.

[nick24]

I think i almost threw up looking at those pictures, they look like sacks of vomit. Just a random question though, what do you do with what you take out of people, throw it away in a special trash can? can you make soap out of it or something, haha

[Dr. Elliot Jacobs]

Nick 24   Good question -- what do we do with the tissue that is removed?

If there is solid tissue from an excision, then it is sent to a pathology laboratory for examination -- just to make sure there is nothing bad going on.  After they examine it, the tissue is placed  in a sealed medical refuse container which is sent to a specific refuse company which specializes in medical refuse.  Under their supervision, the medical waste is incinerated.

If lipo has been performed, it is a liquid of fat, tumescent fluid, some blood and some breast tissue.  In these cases, it is impossible to send it to a lab.  We therefore add a chemical which makes the liquid turn solid.  It is then disposed of through a similar medical waste company and eventually incinerated.

Dr Jacobs

[PSC0002]

Plarkin -

it was a good bit of gland.  My Dr. was Dr. Jeffords in Atlanta. 

As for the drains, I only had them in for 4 days.  Other than them being annoying strange objects attached to your body by long tubes, I didn't find them that bothersome.  I emptied them every 8 hours or so at first (30ccs or so), then by the 3rd day I was only emptying them every 12 hours or so (and down to very little drainage).  I come from a medical background myself, so they weren't that repulsive to me.  I can't imagine not having them - the swelling and pain would have been ridiculous without draining that much fluid. 

I'm sure many people don't require them for their case, but if I were a PS I wouldn't withhold using them on EVERY patient.  Some people need 'em, some people don't.  I did, and it wasn't that bad. 

[DrBermant]

Plarkin -

it was a good bit of gland.  My Dr. was Dr. Jeffords in Atlanta. 

As for the drains, I only had them in for 4 days.  Other than them being annoying strange objects attached to your body by long tubes, I didn't find them that bothersome.  I emptied them every 8 hours or so at first (30ccs or so), then by the 3rd day I was only emptying them every 12 hours or so (and down to very little drainage).  I come from a medical background myself, so they weren't that repulsive to me.  I can't imagine not having them - the swelling and pain would have been ridiculous without draining that much fluid. 

I'm sure many people don't require them for their case, but if I were a PS I wouldn't withhold using them on EVERY patient.  Some people need 'em, some people don't.  I did, and it wasn't that bad. 

If a surgeon has techniques resulting in that much drainage, drains are critical.  However, surgical techniques that result in less swelling, injury, and drainage rarely need drains.  Drains can be a source of infection requiring extended antibiotics, discomfort, scarring, and slowing down healing.  Check out my typical Swelling After Gynecomastia Surgery and Patient Comfort After Male Breast Reduction.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction