Doctor's: Please kindly verify my condition, photo included (In NYC area)

[aeon2]

Hello,

I have been reading up on gynecomastia and discovered this forum (and that surgery exists), which has been a relief. I would greatly appreciate a professional opinion.

Please find attached photos.
I'm nearing 30 years old, and dropped about 75 pounds about 5 years ago, I'm currently 185 pounds, and motivated/on track to being in the 160-165 pound range in the future, as that is the ideal weight I'd like to strive for and maintain.

I'm hesitant about going into surgery in general, and getting to my weight goal will take a while, but I was hoping for some clarity and an opinion on some of my main concerns.

-With the size of my gynecomastia and 'droopiness' of skin that I currently have, would it result in saggy skin hanging down if I were to undergo the surgery where a half circle is cut under the areola?

-Is a liposuction-only approach possible in my case versus surgery?
I am not looking to have a completely flat chest, but rather ending with a 'normal' looking chest overall, while having a significant reduction in the 'moobs'.

-Lastly, I read that there is an option of doing a donut mastopexy, but would want to avoid if possible. Do you think my type of gynecomastia would require this procedure to compensate for potential sagging skin after surgery?

Thank you so much in advance.

[Dr. Elliot Jacobs]

Photos can only show you certain things -- they do not allow for an evaluation of skin elasticity, which must be done in person.

You have lost a considerable amount of weight -- terrific.  And your age is certainly helpful (younger skin retains elasticity for a longer period of time).

In general, when I encounter a patient such as yourself, I opt for minimal scar surgery and give your body the opportunity to self-tighten after surgery, sometimes 6-12 months.  Most guys would like to get the best possible results with the least amount of scars.  Allowing your body to self-tighten can go a long way towards achieving that goal.

After 6-12 months, if there is any residual lax skin, some type of skin tightening may be entertained.  But since some skin tightening would undoubtedly have occurred, there would be less excess skin to deal with and hence any procedure would be much smaller -- with smaller scars.

Best advice is to consult with an experienced gyne surgeon in your area for an opinion.

Good luck!

Dr Jacobs

[aeon2]

Thank you for your reply and insight, very much appreciated!

[Litlriki]

I would agree with Dr. Jacobs.  In younger patients, even with a history of weight loss as in your case, there is still much resilience of the skin, and after a well-excecuted procedure, skin tightening will occur naturally.  Depending on how it looks after a year or so, additional surgical tightening may be needed, but that can typically be done in a secondary procedure.  If it's not needed, you'll avoid scars that would otherwise be permanent. 

[Dr. Schuster]

It's hard to tell from your photos. It looks like the drooping may be due to just the excess skin laxity you have developed as a result of your weight loss (congratulation). You need an exam to tell for sure. There are a number of non-surgical treatments that might help without leaving you with a scar. It will depend on how "tight" you really want the skin. The tighter you want it, the more likely you would need surgery and would be disappointed in the non-surgical results.