I've heard different answers to the same question and was wondering what is the real medical "answer". Is it really necessary to lose weight (fat) before surgery? And if so, then why? I'm still plannin on losing weight before surgery but I was just curious.
Weight loss before gynecomastia surgery is typically better than weight loss after. Losing weight is a coarse tool. You cannot pick where the fat comes from, or for that matter where the fat goes onto.
Men tend to put fat first on the belly and breast. This extra fat hides the natural contour of the muscle and results in big breasts that just does not sale "male."
Weight loss after surgery is a gamble how it will come off. Men tend to put fat first on the chest and abdomen. We take it off those regions last. If your surgeon contours you to your general body fat, and then you lose the weight, and like most it does not come off the chest as much, then it may look like the gynecomastia has come back! For my patients I typically recommend using weight loss as the coarse tool and reserving the plastic surgery for refinement.
Plastic Surgery is not a good tool to "jump start" the process. But it is you who would be gambling.
Plastic surgery will not make an obese person not look obese because of the global fat problem. Reducing the chest fat beyond the global fat also looks terribly distorted. In compromise surgery, a fat person's breast can be made smaller, but the global fat will still not look as good as when the patient actually is able to work on the coarser weight loss issues. The main advantage to the weight loss, is that my patients have told me they feel better, have more energy, and are happier with their lives. However, weight loss will not help with gland and may leave loose skin as a component.
After Major Weight Loss Male Chest Drooping and Sagging may be a factor.
Male Mastopexy Chest Lift Surgery can tighten and lift a loose skin component. Weight loss after chest lift may result in further sagging, drooping, and loose skin. If the skin did not tighten with the original weight loss, why should it tighten after surgery with more weight loss?
Actually when we loosely speak of weight loss, we are really talking about losing fat. You can use a
Body Mass (BMI) Calculator to see where your height and weight factor. However, BMI does not distinguish between fat, muscle, bone or other tissue. A
Body Fat Analyzer can help better understand the fat issue.
How much weight makes a difference? Major weight loss is fairly obvious, however even a smaller weight loss can make a significant different. I just saw a patient 6' 1'' tall who over 2 months dropped from 216 to 205 pounds. His body fat went from 19.4 to 15.6. His weight only changed 11 pounds, but he put on muscle while taking off fat. His breasts were much smaller. His areola diameter shrank from a long axis of 48mm to 40mm (at the same room temperature). The main factor is that he felt better about himself. This is typical for many of my patients who have described their weight loss experiences. The most he ever weighed was 245 pounds, so there was a loose skin component, but not areola sagging. His weight loss helped define my surgical recommendation.
When the body fat is already low, further weight loss tends to show remaining gland even more. I work with many
Bodybuilders with Gynecomastia and other competition athletes who have subtle gynecomastia and very low body fat. For this patient population, I rather sculpt them at their off season weight: so I have resources to work with for my surgery.
For those frustrated with their contours while waiting for weight loss,
No Surgery Body Shaping Garments are a temporary measure that can be valuable. Check how tissues bounce and move with a very good garment in these
movies with and without garments during activity.
Hope this helps,
Michael Bermant, MD
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