Gynecomastia help please!!!

[dharry]

  Hello

 I am 53 years old. I lift weights and do cardio exercise but nothing extreme. I am a few pounds overweight.

I am 5'9" tall and weigh 193 pounds. I plan on never being heavier than 200 pounds. Would I be better off doing surgery at 200 pounds or 180 pounds?

 Thanks for all advice.

[Dr. Elliot Jacobs]

Obviously, if you are planning to go down to 180 lbs, then do so first.  Then do some careful thinking about whether your chest is still bothersome to you.

Surgery is always an option -- even at your age!  Many guys will accept their chest as it is.  But for others, having an absolutely cut and trim chest is a lifelong dream -- and that would require surgery.

Good luck!

Dr Jacobs

[Litlriki]

As Dr. Jacobs has suggested, you might avoid surgery if your chest seems better at 180 lbs., presuming you are able to live at that weight comfortably.  Alternatively, if your chest still bothers you, surgery is probably worth while, and the results should be long-lasting presuming weight remains fairly stable (or is less) post-operatively.

Rick Silverman

[dharry]

  
   Thanks for the replies. I am definitely not happy with my chest when I weigh in the 193 to 200 pound range. I have not weighed under 190 pounds for many years. I am on the stocky side and with advancing age it is very difficult to keep my weight under 190 pounds. Trying to be as realistic as possible.

 I made myself a promise not to go above 200 pounds. I will try to get down to 180 pounds and see if I like the results. If I am happy try hard to maintain 180 pounds.

One question, If I don't like my chest at 180 pounds. Would I be better off doing surgery at 195 to 200 pounds versus 180 pounds? If I do surgery weighing 180 pounds and my weight creeps back up to my normal 193 to 198 pounds, my chest could get flabby? The alternative is to have surgery at 193 to 198 pounds and never let my weight increase above 200 pounds? I would try and keep my muscle mass the same by working out. By doing this wouldn't my chest have a better chance? That would be my vow to myself to continue working out [no problem with that] and keep my weight under 200 pounds. Thanks in advance for any more info.

[Dr. Elliot Jacobs]

Surgery is best done at your lowest possible weight.  However, realistically speaking, if your weight really likes to be around 190 lbs or so, then gyne surgery can be done at that point.  If you should gain a few pounds even after surgery, it should not make much of a difference.

I had a patient who actually gained 40 lbs after his gyne surgery -- and his chest still looked better than his pre-op condition even though he had gained 40 lbs!

Dr Jacobs

[dharry]

 Thanks for the reply Dr. Jacobs.

 I hope I fully understand the weight loss discussion I keep reading about.

 I like the idea of losing weight to see if a person's gynecomastia is improved enough to not have surgery. If it is greatly improved [where surgery isn't required] a person now has huge motivation to keep the weight off, in a sense the weight loss is the surgery. I get that.

 But if the weight loss isn't enough shouldn't a person go into surgery weighing what he can [realistically] maintain. If a person goes into surgery 30 pounds lighter than what he can [realistically] maintain isn't that a bad idea. When he gains the 30 pounds back isn't that counterproductive to the surgery.

Thanks for all replies.

[DrPensler]

My position on weight loss is a bit different than my colleagues .I prefer your weight be at the level it will be maintained at for the foreseeable future.I do not recommend my patients loose excessive weight that changes their BMI (body mass index) for surgery in that in my experience these patients' weight typically increase after the surgery compromising the result.In my hands, the best results for my patients, has been to optimize the result at a weight the patient will equilibrate at for the long term.

[dharry]

 Thanks for the reply Dr. Pensler.

[Litlriki]

I also take Dr. Pensler's approach, encouraging patients to do the surgery at the weight at which they live.  If they lose weight afterwards, the appearance usually improves.  If they gain weight, it may not change much, but if the weigh gain is excessive, it can compromise the result. 

RS