Author Topic: Do you have to be at a certain weight in order to be considered?  (Read 4249 times)

Offline gyno2

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Hey,

Found this website, think its quite awesome.

I've just been told that I may have gynecomastia, im 5.11 and quite overweight. I used to weigh around 19.5 stones, but am now down to 16.5. I'm at the early stage of my consultation (having blood checked etc), but am I too heavy for surgery?
« Last Edit: March 24, 2010, 06:58:02 PM by gyno2 »

DrBermant

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Hey,

Found this website, think its quite awesome.

I've just been told that I may have gynecomastia, im 5.11 and quite overweight. I used to weigh around 19.5 stones, but am now down to 16.5. I'm at the early stage of my consultation (having blood checked etc), but am I too heavy for surgery?

Congratulations on your weight loss!  Does it not feel much better with that weight off?  3 stones or 42 pounds is a great deal of weight. However, it sounds like you are a work in progress.

A BMI Calculator (Body Mass Index) can help to a certain degree, but Body Mass Index does not take into account muscle mass vs. fat. Body Fat Analyzers can help define that issue. My BMI calculator will let you use stones, kilo, or pounds.

Weight Loss Can help with the fat of gynecomastia, but not the gland. Remaining gland, and sometimes the skin can be residual contour concerns.

Weight loss before surgery is usually much better than weight loss after surgery. Weight loss is a coarse tool, Plastic Surgery is better reserved for refinement. This is especially true when tissue sagging is a factor.  Why lift sagging tissue, lose more weight, and see that tissue sag again from further deflation?

Some doctors will operate on anything that comes through the door, but what do the results really look like?  However, 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.

For a doctor who claims that their contouring can help with someone who is obese or with a global fat contour, try to find before and after pictures from many angles. These photos should not have been after a revision surgery to compensate for secondary problems. You should also try to find out what the patient's weight was before and after. The weight, BMI, and body fat should be comparable to your problem.  What normally happens to such compromise cases is that they still look fat, just with slightly smaller breasts.

Weight loss and surgical sculpture is a series of compromises. What suites any one individual will vary.  Ideal sequence that I recommend my patients:

  • Get to a weight you are comfortable living with.
  • Let the skin adjust as much as it will. It can take from 6 to 18 months for skin equilibration after a gastric bypass and major weight loss.
  • Consider Tightening Lower Tissues First. There is little sense to lift the chest and then have a tummy tuck, lower the chest result, requiring a revision chest lift.
  • Then Address the Chest.
  • Use No Surgery Body Shaping Garments as emotional support not to rush the process.

Bouncing redundant flesh also can be a major emotional factor stressing any patient trying to lose weight.  That is why I posted Videos of Compression Garments dealing with gynecomastia and stabilization.

Male Body Fat Distribution tends to put fat on first on the chest and stomach. We take it off those regions last. Low Nipples Look Strange on a Male Chest. Dealing with Excess Skin on the Male Chest is a more complex compromise in that there needs to be a place where the excess skin can be removed.

Hope this helps,

Michael Bermant, MD
Learn More About Male Mastopexy Chest Lift for Sagging Tissues

Offline Dr. Elliot Jacobs

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Once you have arrived and stabilized at your desired weight, there may be some skin laxity that would have to be addressed, as well as the excess tissues underneath.  Skin laxity is due to stretching of your elastic fibers when you are heavy -- and they never quite recover.

An actual design for surgery would require a hands-on physical exam to determine how much (or how little) lax skin there is -- and then different techniques can be used.

Dr Jacobs
Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
4800 North Federal Highway
Boca Raton, Florida 33431
561  367 9101
Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.c

Offline gyno2

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Thank you very much for taking the time out and replying.

I totally agree with you. Also, is weight loss hindered by hormone deficiency? I.e. you cannot begin to lose weight 'properly' until everything is in balance?

DrBermant

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Thank you very much for taking the time out and replying.

I totally agree with you. Also, is weight loss hindered by hormone deficiency? I.e. you cannot begin to lose weight 'properly' until everything is in balance?

You are quite welcome.

Yes, there are certain hormone problems that excessive fat can be a factor. I have seen patients where that problem resulted in continued weight gain until rectified. Then weight loss could take place. Such patients are best evaluated and stabilized by an Endocrinologist. Not all overweight issues are endocrine in origin.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

Offline Dr. Elliot Jacobs

  • Elliot W. Jacobs, MD, FACS
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Losing weight seems to be an American obsession.  Certainly, there are certain hormone irregularities that can affect your weight -- eg thyroid, pituitary, adrenal hormones.  Weight is also determined by your genes -- which you cannot change.  Your daily weight can also fluctuate just based on any amount of excess water or fluid in your body. And the intricacies of fat metabolism and "fat determining hormones" (such as leptin, etc,) are still being worked out.  Very complex, as you can see.

Bottom line, however, is to be in great general health and shape and to have your hormones checked out if you have any questions about them.  Then, when you are ready for surgery, consult with several plastic surgeons (preferably those with large experience in gyne surgery) and choose the surgeon with whom you feel most comfortable and confident.  This is elective surgery -- don't rush into it -- choose your surgeon wisely.

Dr Jacobs

Offline gyno2

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Hey,

Just an update. I got my blood tests back and they're fine except for the hormone test, which seems to be slightly imbalanced - but nothing too unusual. Because of the way things run on the NHS, my doctor has to hand over the next stage of process to the Endocrinologist, and so is writing off to them today. I should hopefully hear back in 1-2 months.

I'm glad that things are moving in the right direction - albeit a bit slow. But I'm confident I'm making progress nonetheless.

« Last Edit: March 26, 2010, 08:01:13 AM by gyno2 »

Offline Grandpa Bambu

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I'm glad that things are moving in the right direction - albeit a bit slow. But I'm confident I'm making progress nonetheless.

One step at a time...

There is a light at the end of the tunnel my friend!!!  ;)

GB...
Surgery: February 16, 2005. - Toronto, Ontario Canada.
Surgeon: Dr. John Craig Fielding   M.D.   F.R.C.S. (C) (416.766.8890)
Pre-Op/Post-Op Pics

DrBermant

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Hey,

Just an update. I got my blood tests back and they're fine except for the hormone test, which seems to be slightly imbalanced - but nothing too unusual. Because of the way things run on the NHS, my doctor has to hand over the next stage of process to the Endocrinologist, and so is writing off to them today. I should hopefully hear back in 1-2 months.

I'm glad that things are moving in the right direction - albeit a bit slow. But I'm confident I'm making progress nonetheless.



Yes, an Endocrinologist is best to evaluate possible endocrine issues. Be patient, it can take some time to carefully assess such problems. That is one of the reasons many of my patients have raved about the temporizing contour improvements that the Body Shaping Compression Garments offer.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction


 

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