Weight and surgery

[confuseddotcom]

Hi

I have recently found this site and I am confident that I have gynecomastia and 1st experienced the problem when I was 12ish (at the time I was fit and healthy with normal weight). I am now 23 and since 18 have increased in weight (now 17.5 stone and 5'10). I am now losing weight as I am confident that surgery will change my life.

I wanted to know when to have surgery? Is it right to lose enough weight to be considered average first? I am concerned that if I have surgery now I won't get the long term result that I want.

Any advice would be greatly appreciated.

Thanks.

:-)

[Dr. Elliot Jacobs]

Losing weight to a more normal weight is ideal prior to surgery.  You will be healthier and the surgeon can do a more definitive operation.

But we don't live in an ideal world.  Many guys have difficulty losing weight because exercise is part and parcel of the weight loss program.  And if they have large breasts, it is both a physical and psychological detriment to the weight loss.

Therefore, in select cases, I will do surgery on someone who is overweight with the understanding that the surgery is really geared to reduce the overall size of the breasts and to make them more manageable.  Then, the patient can be comfortable when going to a gym and exercising.  If they then lose weight, the breasts will continue to become smaller -- but there will be lax skin to deal with.

One must be aware that being overweight only one time in one's life will stretch out the skin.  Whether the surgery is done at a high weight or after weight loss, appropriate surgery will more than likely include some type of skin excess removal -- and that will leave longer and more obvious scars.

Best recommendation is to consult with several surgeons and get their opinions about your particular case.

Good luck!

Dr Jacobs

[DrBermant]

Hi

I have recently found this site and I am confident that I have gynecomastia and 1st experienced the problem when I was 12ish (at the time I was fit and healthy with normal weight). I am now 23 and since 18 have increased in weight (now 17.5 stone and 5'10). I am now losing weight as I am confident that surgery will change my life.

I wanted to know when to have surgery? Is it right to lose enough weight to be considered average first? I am concerned that if I have surgery now I won't get the long term result that I want.

Any advice would be greatly appreciated.

Thanks.

:-)

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.  And yes, my BMI calculator link will work with Stone and Metric units.

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.

For those having compromise surgery before (or without) weight loss, try to 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.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[Dr. Cruise]

Hello confuseddotcom,
From a surgical standpoint, losing weight is helpful especially if your gynecomastia is caused primarily from a fat excess as opposed to primarily a glandular excess. Yes, gynecomastia can be caused by either excess gland or fat. Often, it is a combination of the two. My question for you to think about is "What happens to your gynecomastia when you lose weight?" If the gynecomastia improves this means that your breasts are primarily fat because glandular tissue DOES NOT go away with weight loss. If you lose weight and your gynecomastia does not improve much than you most likely have excess gland. In this case, surgical removal of the gland will most likely be necessary with or without weight loss.

[confuseddotcom]

Hi

I just wanted to add a quick post to say thanks for all your help. I will continue to lose weight and for once in my life am truly motivated for it! I remember having gynecomastia as a kid so I believe it may be gland related as I was slim however I hope it is only weight related. I would love to have surgery if not but will wait until I know.

Thanks once again.

:-)

[DrTeitelbaum]

Hi Confuseddotc,

In the ideal world, it is best for patients to have surgery when they are at the weight that they are likely to live at.  That way we can do the best possible sculpting, blending and contouring. 

In any case, most all men that lose a significant amount of weight never lose as much from their chests as would be ideal.  I see patients all the time who have lost a lot of weight yet their chest still remains disproportionately large.  The funny thing that at surgery, many of them do not have significant amount of glandular tissue; there is just fat that is more stubborn than the fat on the rest of their body.

So long as you have momentum with your weight loss, then continue losing weight.

But weight loss is very hard.  If you have hit a wall and can't budge the needle on the scale, do not despair.  Oftentimes having a little plastic surgery at that point gives the patient the psychological and emotional motivation to get the weight loss in motion again.