Gland mixed with fat

[domsnips]

Hi all was just wondering if the gland is mixed with fat what happens if you lose weight and you lose the fat in the gland wont this make the gland look smaller or is the fat in the gland impossible to get rid of.

[DrBermant]

Hi all was just wondering if the gland is mixed with fat what happens if you lose weight and you lose the fat in the gland wont this make the gland look smaller or is the fat in the gland impossible to get rid of.

Gynecomastia comes in many different sizes, shapes, and forms.  Unfortunately, it can be difficult to distinguish just what is causing the problem.

Men tend to put fat on first their chest and belly regions.  We take it off there last.  Unfortunately, it can be difficult to distinguish just what is causing the problem.  Gynecomastia male breasts can be fat, gland, or most commonly a combination of both.  Sometimes skin and sagging tissues can be a factor.  Pseudo Gynecomastia is supposed to be fat only gynecomastia.  The problem with that "classification" is that in almost every case of gynecomastia I have seen there is some component of gland.  This gland can be very small, but it is present almost all the time.  So do you have Pseudo gynecomastia when there is a 1%, 10%, 50%, or 90% deformity from fat?  Reality just does not work that way.

Defining the problem with photographs sometimes can help.  However, it is impossible to tell from photographs if the deformity is from fat or gland. The dynamic images, of my standard set of images can show a region that compresses differently.  Even clinical examination differentiation can be difficult.

Fat tends to be soft, gland tends to be firm.  Fingers of gland often dissect between fingers of fat.  Look at this drawing and move your mouse over the arrows.  However, gland can be soft and fat firm confusing the picture.  Gland tends to be located under the nipple and pinching pressure can sometimes tether to the nipple pulling it in.

Men with excessive fat do tend to have certain contour issues.  Check out this link about Sumo Wrestlers.  Men tend to carry excessive weight in their chest and stomach.

Weight Loss Before Surgery is typically better than weight loss after surgery.  Losing weight is a coarse tool.  Plastic Surgery is best reserved as a refinement tool.  You cannot pick where the weight comes from, nor goes onto.  Men typically gain weight first on the stomach, love handles, and chest.  We typically take weight off the same areas last.  Major weight loss after surgery may not come from your chest.  If like most men, you do not lose as much from the chest, it may look as if your gynecomastia has recurred.  Some of my patients loose their weight after surgery and get away with it.  However, weight loss after surgery is a gamble.

Getting to a weight you are comfortable with is often best.  Taking weight off, having surgery, and then putting weight back on is a problem.  If as with most men, weight is put on the breasts, it can look like the gynecomastia has come back.

After major weight loss, there may be loose drooping tissues.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[Blue2]

Great explanation, thanks!

[beevis]

Dr. bermant ,Dr. lista said in his Youtube video that it really doesnt matter if you lose weight before the surgery. I saw you about a year ago for a consult and you mentioned that the results would be better if i lost a little weight. i don´t appear over weight and my BMI is good. what is the benefit in terms of outcomes to be at a lower bodyfat percentage going into the operation?

cheers,

beevis

[DrBermant]

Dr. bermant ,Dr. lista said in his Youtube video that it really doesnt matter if you lose weight before the surgery. I saw you about a year ago for a consult and you mentioned that the results would be better if i lost a little weight. i don´t appear over weight and my BMI is good. what is the benefit in terms of outcomes to be at a lower bodyfat percentage going into the operation?

cheers,

beevis

When patients tell me that they are planning weight loss or fat reduction, I typically tell them that weight loss before surgery is better than weight loss after surgery.  Weight loss is a coarse tool. Plastic Surgery is better as a refinement tool.  You cannot pick where weight comes off from.  As a Surgical Sculptor, I prefer the coarse tool first, then the refinement.  Men typically put weight on first the chest and belly and take the fat off those area last.  Do the surgery first, and you are gambling where the fat comes off from with the weight loss.  If the patient is typical, and the chest fat does not come as well, it will look like a recurrence.  Another option is to suck all the fat, leaving a crater defect.  A Crater Deformity Complication Scar, even one widespread across the chest, still does not look good, does not move well, nor appears normal in animation.

Some men do not plan on losing weight.  When they tell me that they are happy at their current weight, compromise surgery is another option.  There are examples on my website where patients have chosen to compromise. They look better after surgery than before, but they still look overweight and not as good as those who choose to lose their weight first.  The problem is that you cannot take an excess weight contour problem and fix it with plastic surgery.  Unless the contouring is done globally, the small region treated can look terrible.

For those planning major weight loss, loose skin and sagging breasts can become a factor.  Male Mastopexy Chest Lift may need to be considered for these patients instead of just gynecomastia contouring.

If you have questions about your specific situation, Jane is my office manager and will be glad to set up a time to continue our disucussion of your options.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[mizuno]

What about patients who are fairly slim and are not overweight? And just mainly have excess weight
in the breast area.