Author Topic: What can I do?  (Read 2789 times)

Offline Bib

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I was pretty overweight my entire life. I've lost that weight now, and my doctor has told me not to lose any more weight, yet I still have man boobs and a saggy stomach... I asked if this was perhaps stretched skin. Apparently it isn't. My muscle mass is fine as well. My doctor has always given me excellent advise and I've been very satisfied with him, he's a great doctor, except I know that men my age (20) do not look like this unless they're overweight. Which apparently I am not.

So what can I do about this? The stomach I can live with, it's really not that bad, but the chest is something I really need to get rid of, and not just for aesthetic's sake.

I'm 5'6, about 175lbs, with a 36-37 inch waist line. My testosterone levels are normal (though I don't think I've ever been checked for estrogen levels, but I have no reason to believe this is hormonal, and my doctor didn't seem to think it was either).

Do I try losing more weight anyways? Do I need to find a different doctor to speak to? I'm sort of at a loss when my trusted doctor, for the first time ever, has shrugged off a problem I'm having just because it isn't a health risk. I've saved up the money for surgery, but I can't seem to find anyone who will tell me if that's the right answer, or if there's another way?

So where do I go from here?

Offline Dr. Elliot Jacobs

  • Elliot W. Jacobs, MD, FACS
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Stretched out skin is an inevitable product of significant weight loss -- even in a younger person who presumably has good skin elasticity.

You are still a bit overweight for your height (ideally) but if you are satisfied with your present weight, suggest you consult a plastic surgeon who may recommend body contouring surgery.  This may involve removal of excess sagging skin of the abdomen and a re-contouring of your chest.

I would be pleased to provide a free evaluation for you if you wish.  Please send an email to me with your name and email addy and I will reply with some important information.

Dr Jacobs
Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
4800 North Federal Highway
Boca Raton, Florida 33431
561  367 9101
Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.c

Offline Bib

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Ideally, if I could go without surgery or other medical procedures, I would... I don't need a quick solution, I just need a solution that will work... If I could build up enough muscle to compensate for the lost fat, no problem... If I could burn the fat out of my chest with pure exercise and diet, fine, that's what I'll do... If I absolutely need liposuction or some other procedure, fair enough.

Everyone keeps telling me that I shouldn't lose weight though. Doctor says that I shouldn't. Family says I shouldn't. Therapist says I have nothing to worry about. But every chart and health guidelines I find tells me I should.

I seem to remember my doctor saying that this didn't seem to be enlarged glands (Gynecomastia), so that's a relief I guess, but the 'symptoms' are all the same to me...

Offline Dr. Elliot Jacobs

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Certainly there is no problem with waiting and exercising, etc.  But unfortunately, no amount of bulging muscles will take up the slack of lax skin after substantial weight loss.

A plastic surgical consultation could probably provide you with sufficient information to make further decisions.

Good luck!

Dr Jacobs

DrBermant

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I was pretty overweight my entire life. I've lost that weight now, and my doctor has told me not to lose any more weight, yet I still have man boobs and a saggy stomach... I asked if this was perhaps stretched skin. Apparently it isn't. My muscle mass is fine as well. My doctor has always given me excellent advise and I've been very satisfied with him, he's a great doctor, except I know that men my age (20) do not look like this unless they're overweight. Which apparently I am not.

So what can I do about this? The stomach I can live with, it's really not that bad, but the chest is something I really need to get rid of, and not just for aesthetic's sake.

I'm 5'6, about 175lbs, with a 36-37 inch waist line. My testosterone levels are normal (though I don't think I've ever been checked for estrogen levels, but I have no reason to believe this is hormonal, and my doctor didn't seem to think it was either).

Do I try losing more weight anyways? Do I need to find a different doctor to speak to? I'm sort of at a loss when my trusted doctor, for the first time ever, has shrugged off a problem I'm having just because it isn't a health risk. I've saved up the money for surgery, but I can't seem to find anyone who will tell me if that's the right answer, or if there's another way?

So where do I go from here?

Congratulations on your weight loss!  Does it not feel much better with that weight off?

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. 

Low Nipples Do Not Look Good on the Male Chest. Redundant skin can deform the chest with a hanging breast like shape.

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 before surgery is usually much better than weight loss after surgery. Weight loss is a coarse tool, Plastic Surgery is better reserved for refinement. This is especially true when tissue sagging is a factor.  Why lift sagging tissue, lose more weight, and see that tissue sag again from further deflation? 

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.

Bouncing redundant flesh also can be a major emotional factor stressing any patient trying to lose weight.  That is why I posted Videos of Compression Garments dealing with gynecomastia and stabilization.

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

 

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