Looking for advice, especially a doctor's opinion

[anon85]

Hi, been lurking for awhile, but first time posting.

I was always a chubby kid, but I realized there was something wrong with my chest around 3rd or 4th grade, when I was mocked for the first time (I was playing a shirts/skins basketball scrimmage). And, I've been too embarrassed to take my shirt off in public ever since. In high school I got pretty thin and it didn't do much for my chest except make it more obvious I had moobs. So, at some point I just gave up and let myself go. I'm 24 now, 6' and the highest weight I ever saw on the scale was 265lb, but I wouldn't be surprised if I was higher before.

Anyway, I discovered this site last year and resolved to lose weight and get surgery. I'm now down to about 190lb and still plan to lose like 30lb or so more. So, what I'm wondering is. . .

What can I hope for as far as results? If someone could direct me to some before/after shots of someone with a similar case, that would be awesome.
Are there any good surgeons in the Chicago area?
Should I wait to get closer to my goal weight before I start seeking a surgeon?
And, where would people put me on a 1-10 scale?

-Thanks

[DrBermant]

Hi, been lurking for awhile, but first time posting.

I was always a chubby kid, but I realized there was something wrong with my chest around 3rd or 4th grade, when I was mocked for the first time (I was playing a shirts/skins basketball scrimmage). And, I've been too embarrassed to take my shirt off in public ever since. In high school I got pretty thin and it didn't do much for my chest except make it more obvious I had moobs. So, at some point I just gave up and let myself go. I'm 24 now, 6' and the highest weight I ever saw on the scale was 265lb, but I wouldn't be surprised if I was higher before.

Anyway, I discovered this site last year and resolved to lose weight and get surgery. I'm now down to about 190lb and still plan to lose like 30lb or so more. So, what I'm wondering is. . .

What can I hope for as far as results? If someone could direct me to some before/after shots of someone with a similar case, that would be awesome.
Are there any good surgeons in the Chicago area?
Should I wait to get closer to my goal weight before I start seeking a surgeon?
And, where would people put me on a 1-10 scale?

-Thanks

Congratulations on the weight loss!  Does it not feel much better at the lower weight?


The male chest can be distorted by both Gynecomastia Male Breast Enlargement. Drooping or Ptosis is a frequent problem after massive weight loss or deflation of massive muscles.   100 pounds is a great deal of weight.  Weight loss can leave a great deal of loose skin in many different parts of the body.  How much loose skin can vary from person to person.  It can take from 6 to 18 months for the skin to tighten after massive weight loss according to the literature on gastric bypass patients.

Posting Standard Pictures to Show Male Chest Drooping after weight loss can help others better understand if the loose skin component is a factor.

Low areola and sagging skin do not give a good contour to the male chest.  Surgery to deal with both the residual contours of gynecomastia and loose hanging tissues can be combined.  Male Mastopexy Chest Lift for Drooping Chest or Ptosis can consist of many different Surgical Options for Excess Skin of the Male Chest.  A Short Scar Skin Reduction Chest Lift hides the scars under the pectoral muscles and around the areola.

Hope this helps,

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

[George Pope, M.D.]

At your current height and weight, I don't think you can afford to lose another 30 pounds.  Six feet tall and 165 pounds?  That's pretty skinny.  You should get a reasonable result with gynecomastia surgery, with a combination of liposuction and direct excision of any glandular tissue you may have.  That will help decrease the diameter of your areolae, but you might later need additional areolar skin removal if the diameters are still too wide.  Building up pec muscle bulk in the gym will help your overall look, and you could start that now, rather than trying to lose more weight.  You will actually gain weight as you lose fat and gain muscle with weight training.  Muscle weighs more than fat at a given volume, so don't worry about putting on a little weight with training.

And your hair and skin color are the perfect combination (light skin, dark hair) for Laser hair removal.  Once you get your new chest, you'll probably want to get rid of excess body hair.  Laser hair removal in the long run will be better than shaving or waxing, but those are obvious options as well.

I don't know any Chicago docs.  I'm in Orlando, FL, a good distance away, but I treat a lot of out of state patients.  You may find someone on this site who can refer you to a Chicago plastic surgeon.

Congratulations on your decision to tackle the gynecomastia.  As many of the guys on this site will also tell you, it'll change your life!

Dr. Pope, M.D.

[anon85]

First, thanks for the responses. They're very helpful. Couple of follow up questions tho...

It can take from 6 to 18 months for the skin to tighten

So do you think it best to wait a bit longer before surgery? I was thinking of aiming for either a summer or winter break surgery (currently a full-time student) so that I would have ample time for recovery.

Oh, and on the topic of recovery, I exercise six days a week, 45 min elliptical on non-lifting days and 30 min on lifting days. Would I have to cut back or stop some of that during recovery? And, if so how long usually? I assume I would have to stop doing any kind of chest exercise for at least a bit, but what about arm/shoulder/or running with arm movement?

At your current height and weight, I don't think you can afford to lose another 30 pounds.  Six feet tall and 165 pounds?

I was told a BMI of 22 was ideal, and for my height 22 is achieved at like 162 lb if irc. So, that's the weight goal I set just to have something to aim for. Really, I'm just shooting for a flat stomach at this point.

[DrBermant]

First, thanks for the responses. They're very helpful. Couple of follow up questions tho...

It can take from 6 to 18 months for the skin to tighten

So do you think it best to wait a bit longer before surgery? I was thinking of aiming for either a summer or winter break surgery (currently a full-time student) so that I would have ample time for recovery.

Oh, and on the topic of recovery, I exercise six days a week, 45 min elliptical on non-lifting days and 30 min on lifting days. Would I have to cut back or stop some of that during recovery? And, if so how long usually? I assume I would have to stop doing any kind of chest exercise for at least a bit, but what about arm/shoulder/or running with arm movement?

The 6 to 18 months are the results of massive weight loss patients.  For a first time pregnancy that distends the skin for a few months, it can take from a few weeks to a few months for the skin to tighten.  For my patients I recommend that they wait until they feel that the skin no longer is shrinking.

Activity after surgery depends on what needs to be done.  But in general, bouncing and stressing the healing tissues can harm early healing and slow recovery.  Comfort is nature's way of telling you what you can, and cannot do.  Recovery is like the healing after a sprain.  Careful gentle pushing while being careful seems to work for most.

At your current height and weight, I don't think you can afford to lose another 30 pounds.  Six feet tall and 165 pounds?

I was told a BMI of 22 was ideal, and for my height 22 is achieved at like 162 lb if irc. So, that's the weight goal I set just to have something to aim for. Really, I'm just shooting for a flat stomach at this point.

6 foot tall and 190 pounds: check the BMI Body Mass Calculator this translates to being slightly into the overweight category.  For some patients, this is as far as they plan to go.  For others, it is not quite enough.  Body Fat Analyzers can help define what percentage of the problem is fat vs. muscle / bone.  If you need surgery to lift hanging tissues and then lose more weight, do you really think your skin is going to shrink after the additional weight loss?  If it is going to shrink, then why not hold off the surgery and see how much?  I have seen horrible disasters from premature surgery done by other surgeons before weight loss was done.  For some of the problems, I did not have reasonable revision options to offer. 

Body Shaping Compression Garments can help give a good contour during the weight loss and many of my patients have expressed how much they helped with motivation.

Patience can be quite valuable for someone looking for a better result.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[DrBermant]

How about adding some pictures of the problem before the weight loss?  Also consider expressing how it feels now after losing the weight compared to how you were before.

[anon85]

How about adding some pictures of the problem before the weight loss?

Earliest photos I have are @235 lb and I'm standing in my more natural, horrible slouch so I'm posting some @190 with a slouch as well...

235


current


235


current

Also consider expressing how it feels now after losing the weight compared to how you were before.

I'm not quite sure what you mean. Emotionally? Or like skin/tissue?

[13genof]

WOW, dude it sure looks like it came back, maybe it's time to get a second opinion.  I think people who are having surgery for Gynecomastia should research if there doctor had Gynecomastia or not and if they had bad experiences while having Gyne, that influences them for pushing plastic surgery when the case is very mild, in opinion.

In my Opinion, it seems that according to you before and after pictures your surgery is very iffy at best, as you feel and my opinion you should have gotten better results!


NO DOC I will not respond to anything you write in response to my post,  I am not pushing my opinion, I am ONLY stating my OPINION!!!!

[crow]

How about adding some pictures of the problem before the weight loss?

Earliest photos I have are @235 lb and I'm standing in my more natural, horrible slouch so I'm posting some @190 with a slouch as well...

235


current


235


current

Also consider expressing how it feels now after losing the weight compared to how you were before.

I'm not quite sure what you mean. Emotionally? Or like skin/tissue?

I still am haveing probs after 3 times in the repair table and 2 years of it........I think it take much time, the right PS, and lose of some bounds........I hope my prob is just the extra pounds and hope it gets better before I get to old....Just keep on with the right attitude and at least you will feel better.

All the best

Crow

[anon85]

WOW, dude it sure looks like it came back, maybe it's time to get a second opinion.  I think people who are having surgery for Gynecomastia should research if there doctor had Gynecomastia or not and if they had bad experiences while having Gyne, that influences them for pushing plastic surgery when the case is very mild, in opinion.

In my Opinion, it seems that according to you before and after pictures your surgery is very iffy at best, as you feel and my opinion you should have gotten better results!


NO DOC I will not respond to anything you write in response to my post,  I am not pushing my opinion, I am ONLY stating my OPINION!!!!

I haven't had surgery yet...I think you must have meant to post in that other thread. Those are just weight loss photos.

[DrBermant]

I'm not quite sure what you mean. Emotionally? Or like skin/tissue?

Emotionally.  How is life different after the weight lost so far?  Have you tried the Body Shaping Garments as a temporizing solution that so many of my patients have used to temporize the embarrassment of hanging loose skin?

In addition, the standard pictures for loose skin of the chest and Pictures to Evaluate Loose Skin of the Stomach and Abdomen are better at documenting the current problem.

Hope this helps,

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

[anon85]

Emotionally.  How is life different after the weight lost so far?

Overall, I feel pretty good about it. I've been surprised at just how quickly I was able to get this far. I thought about weight loss in the past, but never really put much effort into because I was just expecting failure and I knew that it would make it harder to hide my chest. Finding out how common corrective procedures are and discovering this site gave me a lot of motivation to finally take the plunge.
Also, when I was living a sedentary lifestyle I had very little energy or motivation to get out of my chair and away from the computer/tv. Now, I rarely feel lazy, I'm constantly running around, I exercise regularly, and I can't even remember the last time I rode an elevator if there were stairs anywhere in the vicinity. The very first day of doing the elliptical I could barely run even 5 min, and now I've done as much as 70 min. Making that kind of progress in just a few short months feels great.

Have you tried the Body Shaping Garments as a temporizing solution that so many of my patients have used to temporize the embarrassment of hanging loose skin?

I've given these some consideration, but I'm a bit hesitant because I still plan to lose more weight. At $100 a vest it would be expensive to have to replace if it got to be too loose. Though, if I were to get one as a pre-surgery, temporary solution, which would you recommend the 1240 or the 640? (Comfort and visibility through clothing are concerns of mine if there is any difference between the two.)

In addition, the standard pictures for loose skin of the chest and Pictures to Evaluate Loose Skin of the Stomach and Abdomen are better at documenting the current problem.

I will try to get better shots as soon as I can find some time during daylight hours.

[DrBermant]

Emotionally.  How is life different after the weight lost so far?

Overall, I feel pretty good about it. I've been surprised at just how quickly I was able to get this far. I thought about weight loss in the past, but never really put much effort into because I was just expecting failure and I knew that it would make it harder to hide my chest. Finding out how common corrective procedures are and discovering this site gave me a lot of motivation to finally take the plunge.
Also, when I was living a sedentary lifestyle I had very little energy or motivation to get out of my chair and away from the computer/tv. Now, I rarely feel lazy, I'm constantly running around, I exercise regularly, and I can't even remember the last time I rode an elevator if there were stairs anywhere in the vicinity. The very first day of doing the elliptical I could barely run even 5 min, and now I've done as much as 70 min. Making that kind of progress in just a few short months feels great.

Have you tried the Body Shaping Garments as a temporizing solution that so many of my patients have used to temporize the embarrassment of hanging loose skin?

I've given these some consideration, but I'm a bit hesitant because I still plan to lose more weight. At $100 a vest it would be expensive to have to replace if it got to be too loose. Though, if I were to get one as a pre-surgery, temporary solution, which would you recommend the 1240 or the 640? (Comfort and visibility through clothing are concerns of mine if there is any difference between the two.)

In addition, the standard pictures for loose skin of the chest and Pictures to Evaluate Loose Skin of the Stomach and Abdomen are better at documenting the current problem.

I will try to get better shots as soon as I can find some time during daylight hours.

My patients tend to like this Body Shaping Compression Vest as an emotional aid during weight loss.

You can see many examples of this Compression Body Shaping Garment here.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction