Hi, My son is 20, about 5'11" and about 250, he definitely has gynecomastia. I want to know if i should suggest him seeing an endocrinologist or a plastic surgeon. I know this is hindering him from putting himself out there, and my heart breaks for him, as you could imagine. please help ! Mom
Choice of doctor depends on many factors. Which gynecomastia patients should seen by an Endocrinologist has been an issue that a series of Endocrinologists and myself had worked on for years. We evolved a
Red Flag system of
Gynecomastia Symptoms. This methodology was received well during my invited Gynecomastia lecture at a recent American Association Of Clinical Endocrinologists national meeting. The goal is to select which patients would benefit by that evaluation. I never discourage a patient seeking an Endocrinologist's advice. Some overweight conditions have an endocrine origin that need to be stabilized before that person can effectively lose weight.
However, the waiting time to see an Endocrinologist can be extended. Not all endocrinologists prefer evaluating gynecomastia. We work with several endocrinologists here in the United States for our patients who schedule them in a timely fashion. A few of these doctors have adopted variations of our
Preliminary Remote Discussion to minimize travel and to offer second opinions for those with complex endocrinology problems.
Seeing a Plastic Surgeon who specializes in gynecomastia is one way to go, but be careful of the "quick fix" mentality that can profit a doctor and leave unaddressed problems. Look for before and after examples of that specific doctor's early surgery to determine if that is a desired option. Videos on how the tissues bounce after early surgery are particularly revealing as to the compromise of the results.
Have you checked your son's
Body Mass Index with a BMI Calculator? By definition you are almost obese at the high range of overweight. BMI does not differentiate between fat, muscle, and bone.
Body Fat Calculators can help with the fat percentage and are better at helping define the fat component.
5'11" at 250 results in a BMI of 34.9 which is the highest in the Obese category, almost Severely Obese.
Plastic Surgery is not an alternative to losing weight. With surgery, a fat person will still look like a fat person, just one with smaller breasts.
Have you ever seen a Sumo wrestler without breasts? 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.
Weight Loss Before Gynecomastia Surgery can help with the fat, but not the gland. However, you cannot pick where your fat comes from.
Plastic Surgery is also 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. Take some time to look at what those garments have to offer, in particular look at the video. It has been amazing looking at the expressions on my patients' faces after trying on one of these garments. I call these heavy duty compression garments an emotional band-aide. They certainly are much less invasive than "motivational" or "jump start" surgery that may burn bridges and costs a great deal more.
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. Use of a refinement tool first, then the coarse tool of weight loss, and then the refinement tool again can be quite expensive.
Hope this helps,
Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction
