Gynecomastia? Suggestions? Please!

[hatemymoobs]

I've got a few concerns besides my fatty chest. I know I could lose some weight, that's another concern.  
First question is- do I likely have Gynecomastia? I recently worked up the courage to ask my doctor during my physical which was extremely hard to do, and one of those "oh and one last things". He felt them and said it's just fat, however that doesn't change their appearance and doesn't raise my confidence. I still have coney breasts and do everything (including slouching) to avoid them being noticed.
Before I ramble on and tell my life story of how I got to this site- the photos. 5'10" 168lbs. 28 yrs old.








The other concern I have is the hourglass shape my torso has. Even 10 years ago when I was 18 and thinner, I had a slight hourglass torso. So not only do I have the chest of a young girl, I feel like I have lady hips!
While I'm at it, it may also be worth noting my arms, legs, neck, and face are all pretty slim.
Thanks.

[thetodd]

you look overweight, but that looks like gyne to me

your hips look like there fatty to me. If you worked out you could lose them id say youd need surgery on your chest personally

[hatemymoobs]

I've had a hard time between work and family to find time to go to the gym. However I've lost about 8 lbs over the last two months just increasing my water intake and reducing alcohol, caffeinated sugary drinks etc.
I'm hoping to find a way to hit the gym at least a 2-3 times a week, but I also need to get into better eating habits. I'm sure this will help- however my concern is everywhere else on my body looks thin already. My face is thin and if I lost more weight I'm not so sure I'm going to like having a boney face with a long thin neck.

So essentially- I'm wondering is there a way to lose weight in the midsection without losing the very little fat I have in my face, neck, arms and legs? The torso is the only part I have a problem with. Everywhere else isn't too fat nor too thin. They're doable.

Any and all replies are appreciated. Nice to not feel so alone on this....

[balalayka]

Can't tell for sure but you seem to have localized fat deposits on the chest and belly.  This is a normal fat storage pattern for some males. As for losing weight from one area only aka spot reduction everyone will tell you it's impossible; you can't do that. You have to reduce your overall fat. Sometimes this genetically induced fat is almost impossible to get rid of using the strictest of diets....tried to know why but could not find any useful info on the web....only thing I was able to capture was something related to alpha and beta receptors and the ratio between them in these localized deposits. You might end up having lipo to fix these areas; that's the only known solution that works.

As for your hourglass figure, I don't think you have an hourglass figure, I think it's just the fatty love handles. To get a V taper shape, I suggest you train your back at the gym....do deadlifts, pullups, cable/dumbbell/barbell rows. This will help with your figure a lot. Good luck.

[hatemymoobs]

I'd love to hear from one of the doctors on this board their opinion.
Thanks so far for the feedback.

[Dr. Elliot Jacobs]

Although your height and weight translate to a healthy BMI of 25, you do appear to have excess tissues on your chest, abdomen and love handles.  This is very common in men -- these are the areas that we put the fat on first -- and they are often the last go (if at all).  Unfortunately, when one diets and loses weight, one cannot direct one's body on where to take the weight off first.  You might, for instance, lose weight from your face or neck and minimal weight from your chest or abdomen.

This is where liposuction is very effective, for it can directly target the ares that you are concerned about.

As you know, I do a lot of gynecomastia surgery -- and I do think you would be a candidate for such surgery.  I also frequently include liposuction of the abdomen and love handles as well.  I call this a Torso-plasty.  I have an entire section devoted to it on my website. 

Dr Jacobs

[hatemymoobs]

Thanks Dr Jacobs... I really hoped to find a doctor like yourself with plenty of experience in gynecomastia to talk to about my other questions. I'm in Dallas, and you're in New York. 

I'd been reading that successful treatment would involve excising of any gland and liposuction for shaping the breast back to a flatter shape. In a video I just watched of you, you said there's a newer tool that will lipo the gland and fat all through one small slit near the arm pit. I know it's hard to say for sure- but do you think I could get optimal results through a procedure like this?

The main thing I'm concerned about is any scar left behind. I have 1 keloid from a piercing that had been infected and never healed properly. It was infected on and off for a few weeks to a couple months until a keloid started to form. If proper care is taken of a wound can it reduce the risk of a keloid forming? Would you advise anyone and everyone with a keloid to stay away from this type of surgery? I've had moles and stuff removed from my back with no scarring issues other than expected.

Thanks

[Dr. Elliot Jacobs]

I'd been reading that successful treatment would involve excising of any gland and liposuction for shaping the breast back to a flatter shape. In a video I just watched of you, you said there's a newer tool that will lipo the gland and fat all through one small slit near the arm pit. I know it's hard to say for sure- but do you think I could get optimal results through a procedure like this?

Yes -- in most cases, both fat and gland must be removed. I have designed an aggressive cannula which, in many cases, can successfully remove both breast and fat tissue from a chest.  This is performed through a 3-4mm incision on the side of the chest.  However, in some circumstances, I encounter extremely dense breast tissue directly underneath the areola.  In these cases, I do need to make a peri-areolar incision in order to achieve the best result possible.  But in approx 40-50% of my cases, only a small nick in the skin on the side of the chest is necessary.  I never know in advance of the operation - a decision to proceed with a peri-areolar incision is actually made during surgery.  I know other doctors have other techniques -- but I will bet they don't have my cannula.

The main thing I'm concerned about is any scar left behind. I have 1 keloid from a piercing that had been infected and never healed properly. It was infected on and off for a few weeks to a couple months until a keloid started to form. If proper care is taken of a wound can it reduce the risk of a keloid forming? Would you advise anyone and everyone with a keloid to stay away from this type of surgery? I've had moles and stuff removed from my back with no scarring issues other than expected.

Most scars will heal satisfactorily -- as witness the scars on your back.  If a wound is chronically infected (as was your piercing scar), it is not unusual for it to heal as a keloid or hypertrophic scar.  (BTW, it is possible, perhaps, to improve even that scar with an injection of steroid medication).  If indeed I do make a peri-areolar incision, it is carefully sutured and in most cases, it will heal to be virtually indiscernible.

Dr Jacobs

[hatemymoobs]

I know other doctors have other techniques -- but I will bet they don't have my cannula.

There is another doctor, Dr Hamas, in Dallas that apparently uses a special cannula that sounds like what you're describing. I've heard reviews of his surgeries that weren't so great with the cannula only, which makes me hesitant to even get in touch with him.

(BTW, it is possible, perhaps, to improve even that scar with an injection of steroid medication).

Unfortunately steroid injections had no effect on my stubborn keloid. I went to see a dermatologist a couple years ago when it was still a pretty new issue. I didn't get the doctor, but the PA. She suggested we excise it, but didn't mention the fact that there's a 50% chance of it coming back, and is possibly that it would come back worse. That was told to me by the PS I went to see as a second opinion prior to having it surgically removed. Right now I just keep my hair long enough to cover it until someday some discovery is made on how to cure keloids. Hopefully sooner than later.