Ideal Weight for gynecomastia surgery

[gynosurgery]

In the long term, I want to be at 190 lb with a 5-8% body fat without this embarrassing chest.

Now, I am 6''0. Weigh 160 lb.

Which one will have the best result?
1. Keep dieting until I reach 140 lb THEN do the surgery (no exercise involved, I simply do diet with no exercise).
OR
2. Gain weight to 190 lb with 5% body fat (exercise to bulk up to 210 lb then do hard core cut to reach 190 lb with 5% body fat) THEN do the surgery.
OR
3. Tone up (get cut without getting huge) really well to drop the body fat % to <5% (do extreme cardio to cut) THEN do surgery?

To put it simply, what/when is the ideal situation for me to do the surgery if my long term goal is to be 190 lb with 5% body fat body builder look (right now I am 6''0 - 160 lb with no muscle definition - skinny build)?

[DrBermant]

In the long term, I want to be at 190 lb with a 5-8% body fat without this embarrassing chest.

Now, I am 6''0. Weigh 160 lb.

Which one will have the best result?
1. Keep dieting until I reach 140 lb THEN do the surgery (no exercise involved, I simply do diet with no exercise).
OR
2. Gain weight to 190 lb with 5% body fat (exercise to bulk up to 210 lb then do hard core cut to reach 190 lb with 5% body fat) THEN do the surgery.
OR
3. Tone up (get cut without getting huge) really well to drop the body fat % to <5% (do extreme cardio to cut) THEN do surgery?

To put it simply, what/when is the ideal situation for me to do the surgery if my long term goal is to be 190 lb with 5% body fat body builder look (right now I am 6''0 - 160 lb with no muscle definition - skinny build)?

In general weight loss before surgery is better than after, losing weight being the coarse tool and surgery better reserved for refinement. I advise my patients to get to a weight they are happy with before considering surgery. There are two exceptions.

I work with many bodybuilders and athletes with gynecomastia. Some have body fat percentages so low for competition, that there are just few resources to work with. To be able to target gland first and minimize risk of recurrence, having some local fat resources enables my Dynamic Technique. No fat, and it can become a struggle. For these men, I ask to work on them at their off season body fat so there are resources. This becomes a critical factor when you are looking for results that look good flexing, lifting arms up overhead, living life, playing sports and other activities when leaving firm gland behind that does not compress like fat shows through.

I had seen so many unhappy patients done elsewhere with this gland left behind I named the deformity "Puffy Nipple Complication After Gynecomastia Surgery"  and documented the deformities and surgical correction options and results. By having a little local fat, I can target this gland first and then use the small amount of local fat to keep the nipple from collapsing. Such issues demand more than just a still picture from the front and a side view. You need to see the flexing, arms up, videos of how tissues move.

The second exception is for the many complications I see with patients having major crater deformities after surgery done elsewhere. When these patients have a global fat component of their contour problem there is a no win situation. Although losing weight is better for them in general, that weight loss may then result in not having resources left to rebuilt the mess from the other surgeon. I spend a great deal of time outlining the risks benefits and alternate care issues so they can better understand their options and limitations of too soon a surgery vs  later weight loss unpredictability.

Hope this helps,

Michael Bermant, M.D.

[gynosurgery]

Thanks for the answer! So my weight right now technically is the ideal weight to do the surgery... I have little muscle and just enough fat at 160 lb 6''0.

[DrBermant]

Thanks for the answer! So my weight right now technically is the ideal weight to do the surgery... I have little muscle and just enough fat at 160 lb 6''0.

On a forum I discuss general issues and concepts. I prefer to offer specific advice during a consultation or our preliminary remote discussion. Only after better understanding a patient's specifics can I then give a valid opinion. Any doctor who give specific advice can be establishing a doctor patient relationship and possible responsibility for that advice.

Hope this helps,

Michael Bermant, M.D.