Question

[canadian1000]

I am a 22 year old male, 5'10", and about 60 lbs over weight.... I have long suspected that I have gynecomastia because I always remember having this problem with my chest, ever since I was going through puberty.

Anyways, my question is whether or not Dr. Fielding will require me to lose all 60 lbs before I can have the surgery. Is it a requirement that you first lose all of your excess weight?

Also, how does one tell the difference between legitimate gynecomastia and just being a fat arse? I mean, I am a big guy and I have seen some pictures of gynecomastia that look like what I have, and many that don't... I don't have puffy nipples, but my breasts are triangular from the side view and when bending over, they hang pretty well.

Any answers would be appreciated,
Thanks.

[DrBermant]

I am a 22 year old male, 5'10", and about 60 lbs over weight.... I have long suspected that I have gynecomastia because I always remember having this problem with my chest, ever since I was going through puberty.

Anyways, my question is whether or not Dr. Fielding will require me to lose all 60 lbs before I can have the surgery. Is it a requirement that you first lose all of your excess weight?

Also, how does one tell the difference between legitimate gynecomastia and just being a fat arse? I mean, I am a big guy and I have seen some pictures of gynecomastia that look like what I have, and many that don't... I don't have puffy nipples, but my breasts are triangular from the side view and when bending over, they hang pretty well.

Any answers would be appreciated,
Thanks.

The real question should be: What does gynecomastia surgery results look like on someone who is 60 pound overweight?

The answer is better than before, but not as good as the results would be if you got the extra weight off before surgery. Try to find before and after surgery pictures of overweight men having surgery to see what I mean. Check out before and after pictures from many different angles.  (You should carefully evaluate results with more than just one or 2 views for each patient, especially if those views change from patient to patient. Plastic Surgery is not an alternative to losing weight.  A fat person will still look like a fat person, just one with smaller breasts.

The problem is that Male Fat Pattern extends around the chest, under the arms, and around the back.  Plastic Surgery is not a good tool for a global fat problem.

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.

The biggest change I have noticed over the years, is that patients who lose weight tell me that they feel so much better about themselves. It often changes the front to a degree, but the sides and back can see a major benefit from getting the excess total body fat under control.

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.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[Grandpa Bambu]

Anyways, my question is whether or not Dr. Fielding will require me to lose all 60 lbs before I can have the surgery. Is it a requirement that you first lose all of your excess weight?

Probably not dude... I was about 40 lbs OW at the time of my surgery. I had lost 20 lbs prior to surgery though.
 

Also, how does one tell the difference between legitimate gynecomastia and just being a fat arse? I mean, I am a big guy and I have seen some pictures of gynecomastia that look like what I have, and many that don't... I don't have puffy nipples, but my breasts are triangular from the side view and when bending over, they hang pretty well.

Any answers would be appreciated,
Thanks.

The term 'Gynecomastia' means...  Woman-like-breasts.  Therefore, if your chest resembles that of a woman, in any way shape or form, then you have Gynecomastia. There's no such thing as 'True Gynecomastia' or 'Legitimate Gynecomastia' or 'Pseudo Gynecomastia'. Gynecomastia is Gynecomastia...

Gynecomastia takes on many shapes/forms. From slight 'Puffy Nipples' (actually it's the areolas that are puffy, not the nipples) to full-figured breasts and anywhere in between.

Gynecomastia is NOT a weight issue! You cannot exercise stubborn adipose tissue away. I cannot for the life of me, understand why many guys here think that if the G sufferer is a few pounds over-weight, it must be this so-called 'Pseudo G'. The reason why so many G sufferers are overweight, is that they withdraw from physical activities from fear of being ridiculed for having m(o)(o)bs. As a result, they put on the pounds.

Dude, don't beat your self up over the fact that you are over weight. If you have m(o)(o)bs, then you have Gynecomastia.

Peace Brother!

GB...

[shirtshy]

The reason why so many G sufferers are overweight, is that they withdraw from physical activities from fear of being ridiculed for having m(o)(o)bs. As a result, they put on the pounds.

Not to mention that we're trying to hide our moobs by being overall 'proportionally' fatty! 

I would say that it seems like the surgery (my surgery) would have been more effective if I did lose some more weight before surgery.  It's not easy for the doctor to distinguish precisely where the adipose stops, and the exercisable fat starts.  So I'm left with some fat under my arms that I don't know YET if exercise will get rid of.  What if it's adipose and just remains while the rest of me gets more lean?  It doesn't look bad now, but the fat kind of gets in the way when I put my arm down!  I really hope it goes away, but if I had exercised I would know either way.  In that sense, think of exercise as a revealing tool for the doctor, and try shedding some fat if you can.

** I also found massaging my breasts squeezing quite strongly several weeks before surgery 'popped' some fat globules away from gland, or that's what it felt like.  And by the time surgery came they were significantly smaller.  ANYWAY that's my experience.  I haven't heard or read anything about it... other than massage for cellulite on women.

[Grandpa Bambu]

Have you considered asking JCF for a revision surgery to get the under arm tissue?

GB...

[shirtshy]

Hey GB,

Yes I have thought to ask about revision and indent concerns when I meet up at the 2month mark.  There has been some improvement, but I'm still not happy with the wonkiness.