Weight for surgery

[Shamhid]

I'm going to university in two months and can't deal with these ... judging by the 'gland test', I'm entirely fat (pseudo), but the appearance is the same whether they're fat or gland or mix. I'm just shy of 300 lbs and could lose to maybe 260 by the time classes start, but that'd make no large difference - may just make them sag more. I'll be staying in a dorm.

Would a surgeon remove them at my weight? As in, liposuction and excess skin. I don't mind and will lose my belly the hard way, but the breasts I can't stand - they destroy my confidence. Their size has been consistent for years, as I've hovered around this weight for a good 4-5 years.

[Dr. Elliot Jacobs]

What you are talking about is what we term "compromise" surgery -- done to help you get by and temporize until you lose additional weight.

The problem with this is that your skin has lost much of its elasticity, so the removal of excess tissue (fat and breast tissue) will only give you a smaller and probably more droopy breast.  You will still have breasts, albeit somewhat smaller ones.  And then, with a smaller chest, your abdomen will seem to stand out even more.

Basically, at your weight, it is an expensive, lengthy operation which will not help you significantly -- you will still need more surgery in the future (once you have lost weight) to remove additional tissue, remove excess skin and elevate the nipples to a more appropriate location.

Your best bet would be to use some body shaping garments while you make a determined effort to lose substantial weight.  If you are first entering university, the tendency is to put weight on.  But perhaps you can use this new phase in your life to effect just the opposite -- taking weight off by changing your lifestyle.

Best of luck!

Dr Jacobs

[Shamhid]

The night I typed that post, I had a mini-breakdown: anonymity mixed with the stress of an impending college move and self-image issues over my weight caused a rant. I've been intending to wear a compression garment, if anything, as overweight people aren't exactly uncommon these days and the majority of the perceived problem goes no further than my head. That said, I will have a roommate in the dorm and would have to go through more than a few pains to hide the garments/change into them.

Question is: after a half-decade at this weight, does my skin even have any elasticity left? Will surgery post-loss be a necessity?

[Dr. Elliot Jacobs]

If you have been significantly overweight or obese, even for a short time, it will have stretched out your skin and decreased some of its elasticity.  And the elasticity is absolutely necessary for the skin to tighten by itself after the excess underlying tissues have been removed.

I have seen remarkable tightening of skin, even in a formerly overweight patient, in adolescents.  In late teens, the tightening is lessened and in adult men there is only minimal to moderate skin tightening (all after being overweight).

Therefore, it is impossible to predict how much your skin would tighten after weight loss or surgery -- but it will tighten somewhat.

If you lose substantial amounts of weight on your own, however, it is doubtful that your chest would escape the need for some sort of skin tightening procedure in the future.  Sorry, but that is reality.

Dr Jacobs