Surgery whilst overweight?

[your]

Hi everyone

I've booked inconsultation sessions with a number of surgeons for the next month but wanted to get an objective answer beforehand.

Is it generally recommended to get to your target weight before the surgery or will surgery be successful even if you have a few extra pounds?

I'm 5'10 and around 14st (195 lbs).   I have quite pronounced gyno and can tell that weightloss might help but wouldn't get rid of the problem.

Many Thanks

[Dr. Elliot Jacobs]

You are correct-- weight loss will not totally get rid of your gyne.  But if you can lose weight, the entire surgery will be better and of course, you will be that much healthier. 

Many men, however, are unable to lose weight because their gyne is a source of embarrassment and they do not go to a gym because of it.  It then becomes a "catch-22" situation --- they can't/won't exercise to help lose the weight and yet they need to lose the weight to be better candidates for surgery. 

Sometimes I will operate on these men.  The surgery should be thought of as a "compromise" operation -- done to help them look and feel better about themselves.  And then, armed with a more comfortable chest and with more self esteem and less embarrassment, these men will be able to go to the gym and continue to lose weight --- and then whatever excess tissue has been left on their chest after surgery will improve as well.

Dr Jacobs

[DrBermant]

Hi everyone

I've booked inconsultation sessions with a number of surgeons for the next month but wanted to get an objective answer beforehand.

Is it generally recommended to get to your target weight before the surgery or will surgery be successful even if you have a few extra pounds?

I'm 5'10 and around 14st (195 lbs).   I have quite pronounced gyno and can tell that weightloss might help but wouldn't get rid of the problem.

Many Thanks

Have you checked your Body Mass Index with a BMI Calculator?  By definition you are 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.

Plastic Surgery is not an alternative to losing weight.  With surgery, an overweight person will still look like a overweight person, just one with smaller 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.

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.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[TheOregonKid]

According to the simple BMI scale, your BMI is 28.  This means you are overweight but not obese(30+).  A 'normal' BMI is 18.5 to 24.9.  This means that high normal for you would be no greater than 173.5 lbs.  BMI has come under fire in recent years because it fails to take muscle/skeletal build into account.  For example, many bodybuilders would be considered overweight despite having very low body fat(because of their above average muscle mass).  For most of us, however, BMI is a reasonable rubric for determining a healthy body weight.  There are several other formulas for determining ideal weight.  The MetLife scale allows you to classify your build as small, medium, or large, however this method has largely fallen out of favor.  One called the Devine Formula places ideal weight for men at 23kg/m2 and 21kg/m2 for women.  The Robinson Formula is a modified Devine Formula that considers height.  Other formulas include the Hamwi and the Miller Formulas.  All of these formulas vary.

For example, I am 6'0" and 170 lbs.  According to the different formulas, my ideal weight is as follows:

Devine: 171 lbs
Robinson: 165 lbs
Miller: 161 lbs
Hamwi: 177 lbs

Despite being relatively tall, I have a very slender build.  You can see my pictures here: http://www.gynecomastia.org/smf/index.php?topic=21680.0

While I am definitely within my normal, healthy weight range, I feel that I am about 10 lbs heavier than my ideal weight.  I can easily grab about an inch of fat on my stomach and about half an inch on my ribs.  I would say that the Miller recommendation of 161 lbs would be perfect for me.  However, if I had a big build with larger bones and more muscle, the Hamwi would be better.  From what I have read, the Devine Formula is the most popular because it is oftentimes the median of the various formulas and best determines the ideal weight for people with an average/medium build.  I'm sure that some doctors prefer one formula over the other.

There is a great website called halls.md that allows you to input your weight, height, age, gender, and build type and it spits back all the different values for you.  If you Google "Ideal Weight Calculator" it should come right up.

I hope this helps.

-The Kid