Shapes and Appearances

[axe]

I was doing some research on Gynecomastia, and after seeing some post-op pics, I am really confused about the appearance of the chest after gynecomastia surgery.  

So, I have downloaded some pics from some websites that show what I'm talking about.

From the photos I suppose that if you have a skinny body or if you develop some muscle mass in the chest area the results are somewhat positive, I mean, the chest does not appear so droopy and stretched abnormally, as is shown in some of these photos.
Most of the postop(which is normally 1 month in all of the below pics) photos have either skinny or a litte bit muscular people, that have gotten the best looking chests after op.

Or maybe it gets normalized over time of 3 or 4 months, as you slim down and develop some chest muscles.

I don't know much, but if you have any knowledge as to how the shape occurs or what to do to get a normal shape, that'll be a big big help. Guys if you've gotten the surgery done please feel free to share what you think about this.

Here are the pics:

Not so good looking:




(This one looks like it would improve if the person got slimmer.)
None of the people in this category have slimmed down, they're the same body size as they were before


Some good looking ones:


This guy really worked on his body, he's gotten very thin after his surgery, and his chest looks very normal and in accordance with his body.


Best results:
This guy is the best recovery I've seen, he has also slimmed down and toned some of his pecs.





Also really good.

[Dr. Elliot Jacobs]

You bring up an interesting point -- "why don't all post op results look good or very good?"

The answer, though, is very complex.

First, a surgeon can be compared to a sculptor. He is limited in what he can do by the material with which he works.  A sculptor who works with wood cannot do the same work that a sculptor who works in metal or stone can do.

Surgeons deal with live human beings.  There are many factors that enter the equation about what can be anticipated as a final result.

Age:  As we age, our skin loses elasticity.  And it is the innate skin elasticity which will determine the type of procedure which would work for a patient.  Large breasts on an older man will almost always require skin excision and nipple elevation of some type.  Younger patients, even whose with larger breasts, can often get away without skin excision.

Weight:  Being overweight will stretch out skin (and even induce more growth of breast tissue) -- and this weight induced loss of elasticity is a one way street.  There is no way to restore elasticity to skin.

Breast size:  Obviously, those men with a small amount of gyne are better surgical candidates that those with large or even pendulous breasts.

General health:  Healthy individuals will heal better and faster than those with chronic diseases.

The surgeon's skill and expertise in performing gyne surgery:  this is obvious.  The surgeon should try to remove as much tissue as possible while leaving enough tissue so that the chest skin and fat layer is consistent with the surrounding body.  Otherwise, a crater deformity could occur.

Following the surgeon's post op instructions to the "T"   this too is obvious.

Major asymmetry is difficult to correct:  differences in size, nipple position, etc are difficult to correct with minimal scar surgery.  Larger breasts have more stretched out skin, which means that there may be slightly more extra skin on one side than the other once all healing has occurred.

And finally, Mother Nature, which can affect the healing process anywhere along the way, including the production of excess scar tissue.  This is under the control of neither the patient nor the surgeon.

It should be obvious, then, that those guys who get the very best results and who heal the fastest are those with moderate sized gyne, who have never been significantly overweight, who are relatively young and who are healthy. It's also a plus if they follow their surgeon's instructions. That's the ideal situation.  But not all men fall into this category and most guys would willingly accept a significant improvement (but not perfection) in their chest.

That doesn't mean that everyone else should forget about improvement.  As can be seen on some of your photos, many of these men have very significant improvement and although they be overweight or have lax skin, they are undoubtedly pleased with the results.

Some other thoughts.  Oftentimes those guys who may not be ideal candidates will then "get with the program" once their major gyne is reduced.  Over the years, I have seen some guys really turn it around and build muscle / lose fat and really change their physique (and their lives).  Their gyne surgery was just the impetus they needed.

Hope this has provided some insight for you.

Dr Jacobs

[hammer]

Dr. Jacobs, that was excellent! I don't know if you answered the posters qustion but you said a lot that hopefully will help others understand that there can't be perfection at the end of the tunnel in every case!

I know that you gave me some tools when it comes to explaining why I won't ever have reduction surgery giving the size that I am.

Thank you,

Bob

[axe]

Dr Jacobs, that was very insightful and nicely explained.

And from your answer I surmise that there is no way to ensure a good appearance post-op, but one can ensure a healthy body by reducing the fat through regular exercising and try to remain as healthy as possible and also give up any drinking, smoking, or drugs habits. That would ensure healthy being and proper maintenance of vital organs.

Although most other things like fat, health can still be taken care of and restored to an optimal state. But the question remains at elasticity, for those people(myself included) who didn't know anything about these elasticity and other issues before, are there any ways to restore elasticity of skin.

Your replies are very helpful for us and all the other gyne patients. Kindly share your knowledge on this question too.

Thank you very much.
Dr Jacobs.

[Dr. Elliot Jacobs]

I always stress that one should try to have their gyne surgery at their lowest and most stable weight.  Obviously, bringing a healthy body to the operation will help you to heal well.

Unfortunately, there is no way to restore lost elasticity to the skin.  That is why, in the extreme case, people who have lost weight through gastric bypass surgery or lap band surgery, will end up with a lesser weight but also with lots of stretched out skin, some of which will hang down. 

Younger patients (ie teens) who may be obese seem to retain the elasticity and their skin tends to tighten better than those who are 20 or older.

Dr Jacobs

[axe]

Okay, Doc, I get it now. You just have to slim down and tone your body, get to a lowest possible weight and a stable state and take care of your skin, especially the chest skin to retain whatever elasticity is left.

That was really good info. on the subject. I think it'll help many people to learn about these things early on, and get better results.

Dr. Jacobs, you are awesome.