Need professional opinion

[chae]

Over a year ago, I lost roughly 100 lbs. Despite my weight loss and consistent exercise regimen (I lift weights 4 days a week and do cardio or martial arts 2-3 a week), I've noticed -- while there has been some improvement -- my lower chest is still a bit saggy. I recently learned of Gynecomastia and decided to do some research online. I realize that pictures are no substitution for an actual live consultation, but I would greatly appreciate it if you could take a look at the below pictures and provide some input.

http://img836.imageshack.us/img836/7537/imag0001o.jpg
http://img248.imageshack.us/img248/7853/imag0002pp.jpg
http://img842.imageshack.us/img842/6042/imag0003v.jpg

Do I have Gynecomastia? or is it loose skin on my lower chest? or is there still fat?
Re: my abdominal area, is there loose skin there? or still fat?
Any recommended courses of action (non-surgical and surgical)?

Any additional comments and guidance is greatly appreciated! thanks!

[DrBermant]

Over a year ago, I lost roughly 100 lbs. Despite my weight loss and consistent exercise regimen (I lift weights 4 days a week and do cardio or martial arts 2-3 a week), I've noticed -- while there has been some improvement -- my lower chest is still a bit saggy. I recently learned of Gynecomastia and decided to do some research online. I realize that pictures are no substitution for an actual live consultation, but I would greatly appreciate it if you could take a look at the below pictures and provide some input.

http://img836.imageshack.us/img836/7537/imag0001o.jpg
http://img248.imageshack.us/img248/7853/imag0002pp.jpg
http://img842.imageshack.us/img842/6042/imag0003v.jpg

Do I have Gynecomastia? or is it loose skin on my lower chest? or is there still fat?
Re: my abdominal area, is there loose skin there? or still fat?
Any recommended courses of action (non-surgical and surgical)?

Any additional comments and guidance is greatly appreciated! thanks!

Congratulations on your weight loss!  Does it not feel much better with that weight off?  100 pounds is an amazing amount of weight loss!

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

From the pictures shown, it is not possible to tell if the nipples are low. Standard Pictures to Show Gynecomastia and Loose Skin Issues After Weight Loss. Some are able to lose weight and not have a loose skin component.  This is not a black and white defined issue, but one of grays and subtleties.

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? 

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.
• After Massive 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.

The remaining fat and sagging can be stressful for a work in progress, being patient, finishing off the weight loss first is a better option.

Hope this helps,

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

[chae]

Dr. Jacobs?
Dr. Silverman?

Any input?

Thanks in advance.

[DrBermant]

Re: my abdominal area, is there loose skin there? or still fat?
Any recommended courses of action (non-surgical and surgical)?

Any additional comments and guidance is greatly appreciated! thanks!

For loose skin of the abdomen, your images just do not demonstrate the details needed. I use my Standard Stomach / Tummy Tuck Pictures to demonstrate the degree of loose skin. An in office examination is superior, but we see so many patients from around the world that starting out with pictures like I demonstrate is a great first step and often can result in tentative surgery scheduled just from that analysis alone.

After that much weight loss, there will be some loose skin in all locations. Options depend on many factors.

A great temporizing measure for my patients planning to continue losing weight or changing remaining fat into muscle has been ourNo Surgery Body Shaping Garments which will contour and stabilize tissues: an emotional band-aide until tissues stabilize.

Hope this helps,

Michael Bermant, MD
Learn More About Tummy Tuck Abdominoplasty Surgery