Lost tons of fat, but still have some to lose. Surgery now or later?

[burntoast]

Hi all.. I am happy to have found this resource. I am looking for some feedback on my gynecomastia.

I have had a "wide chest" since early teens. Through highschool I gained a bunch of weight due to self-esteem problems, which in-turn kept lowing my self-esteem even further. It was a vicious feedback loop. After my first year of university I think I was upwards of 320lbs, but am not certain as scales wouldn't read that far!  

Anyhow, That was 4-5 years ago. Today I am 243lbs (6'1"), and have become quite active. I lost weight by adjusting my diet over the last 1.5 years, and in the last 3 months I have begun exercising regularly. I am 27 years old.

Regular exercise has formed muscle and reduced the over-all fat on my body, but I do not feel like my chest is reducing in size proportionately to the rest of my other noticeable areas. That's not to say that I haven't noticed a difference, because I have.. but I wonder just how good it will get.

After caliper tests and such, my body fat was measured at 24%, meaning I have approx 60lbs of fat to 180 lbs of lean mass. I except that I can lose ~40lbs just as "easily" as I've lost the other 80, but I have a feeling that my years of obesity and poor posture have done irreparable damage.

So.. Should I be getting surgery now? Should I lose more weight first to see what happens? Even if I lose weight, will I likely still need surgery?

Experts, please comment!

[Raider Fan]

No question, you will have to have surgery to get rid of your gynecomastia.  If your gynecomastia is not in an "active" state and has stabilized, then there's no reason not to get the surgery as soon as possible.  The sooner you have the surgery by an experienced, competent plastic surgeon, the sooner you'll be rid of your condition and a happy man.

[xoxoxoxo]

congrats on the weight loss buddy but i think it's really a gyno and you could just rid of it by means of surgery..

[burntoast]

Thanks for the input, guys!

What I'm really wondering is if I should get it done now or wait until I've lost an additional 30-40lbs? I'd really like to have this thing all sorted out before I start travelling in 8 months. I believe I can lose the at least another 30lbs by then...

I'm asking on here because I've checked with local surgeons and they want to charge me $100-150 for a consult fee, which I'm willing to pay, but not if they're just going to tell me "come back when you've lost more weight." You know?

[dwl]

I'd just do it.   I'm a bit overweight, and I'm in the same situation with travel.   

Here's a link to my pre and post op pics.   Even though i have a few pounds to lose, I'm happy with the results and glad I did it now.

http://www.gynecomastia.org/smf/index.php?topic=21427.msg145642#msg145642

Good Luck!

DWL

[burntoast]

Amazing results, DWL. Very inspiring!

I'm in Canada and I still have a bit more research to do about paying for this type of surgery.. but I'm sure I'll be getting it done asap.

[dwl]

Just be prepared to buy new shirts.    

I found that most of my shirts are too big now because I tried to hide my chest.   

[burntoast]

Haha! That's a preparation I'm more than willing to make!

I discovered recently that if I purchased tight-fitting, non-cotton shirts (polyester, nylon, spandex blend) shirts from sports stores and squeezed myself into one, then threw another shirt on over top, it looked 1000% better... this discovery is pretty much what's fueling my desire to get the surgery, because I want to look that good without a shirt! haha.

[Raider Fan]

What I'm really wondering is if I should get it done now or wait until I've lost an additional 30-40lbs? I'd really like to have this thing all sorted out before I start travelling in 8 months. I believe I can lose the at least another 30lbs by then...

The doctors on this site have commented endless times that's it's really best to lose as much weight as you can (or need to) prior to the surgery.  That's not to say that they won't do it if a person is a little overweight, just that they prefer to do it when the person is within their recommended weight range.  The whole procedure just goes better when they aren't having to fight with excess fat, and doctor and patient are happier with the results.

[burntoast]

What I'm really wondering is if I should get it done now or wait until I've lost an additional 30-40lbs? I'd really like to have this thing all sorted out before I start travelling in 8 months. I believe I can lose the at least another 30lbs by then...

The doctors on this site have commented endless times that's it's really best to lose as much weight as you can (or need to) prior to the surgery.  That's not to say that they won't do it if a person is a little overweight, just that they prefer to do it when the person is within their recommended weight range.  The whole procedure just goes better when they aren't having to fight with excess fat, and doctor and patient are happier with the results.

I will admit that I posted these photos before reading though the countless threads with that advice. I believe I will attempt to lose another 20-30 lbs (3-4 months) before going for a consultation.

[Paa_Paw]

It is probably best to get to the weight you are comfortable with and allow that weight to stabilize for a few months before considering surgery.

Having your weight yo-yo up and down can make problems. When you are carrying around a surplus of fat, the hormone levels tend to be skewed toward the estrogens and this can cause increased glandular growth.

[DrBermant]

Hi all.. I am happy to have found this resource. I am looking for some feedback on my gynecomastia.

I have had a "wide chest" since early teens. Through highschool I gained a bunch of weight due to self-esteem problems, which in-turn kept lowing my self-esteem even further. It was a vicious feedback loop. After my first year of university I think I was upwards of 320lbs, but am not certain as scales wouldn't read that far!  

Anyhow, That was 4-5 years ago. Today I am 243lbs (6'1"), and have become quite active. I lost weight by adjusting my diet over the last 1.5 years, and in the last 3 months I have begun exercising regularly. I am 27 years old.

Regular exercise has formed muscle and reduced the over-all fat on my body, but I do not feel like my chest is reducing in size proportionately to the rest of my other noticeable areas. That's not to say that I haven't noticed a difference, because I have.. but I wonder just how good it will get.

After caliper tests and such, my body fat was measured at 24%, meaning I have approx 60lbs of fat to 180 lbs of lean mass. I except that I can lose ~40lbs just as "easily" as I've lost the other 80, but I have a feeling that my years of obesity and poor posture have done irreparable damage.

So.. Should I be getting surgery now? Should I lose more weight first to see what happens? Even if I lose weight, will I likely still need surgery?

Experts, please comment!

Congratulations on your weight loss!  Does it not feel much better with that weight off?  80 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 image shown, it is not possible to tell if there is a loose tissue factor. 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 and Reduction

[Dr. Elliot Jacobs]

Not only have you had a terrific amount of weight loss (congrats!!) but your skin appears (although can't prove without a physical exam) to have weathered the weight loss well -- with some but not major loss of elasticity.

My feeling is that you will need some sort of gyne surgery in order to achieve the taut, trim and contoured chest that you obviously desire.  In order to get the very best possible result, would strongly recommend that you get to whatever weight you are most comfortable and stay at that weight for at least a few months to stabilize everything.  Then consult with a plastic surgeon who is experienced in gyne surgery.  You may need not only a removal of the excess tissue underneath the skin (fat and gland) but some type of nipple elevation and skin tightening as well. 

These procedures can be combined in one operation if necessary.

Best of luck -- and keep us informed of your progress.

Dr Jacobs

[lezgetitdone]

Wow great job.  If I were in your shoes I would drop to about 225lbs which would make you very lean at your height. 

I personally dropped from 230-170 and I stayed about 1.5 months at 170 range then did the surgery.

[burntoast]

Thank you Dr. Bermant and Dr. Jacobs for your professional advice. I will take it to heart.

I've readjusted my plan of action based on everyone's comments. Thank you very much! I REALLY want to have this surgery done, and have myself recovered by May 2011.

My plan is to now lose as much weight as possible over the next 4-5 months, and I believe I can shed another ~25lbs of fat. By Jan to Feb 2010 I should be in a "good place" weight-wise, as well have gained a decent amount of muscle. I've actually found that I am gaining muscle quicker than I thought, and I know it's affecting my "weight" on the scale. I am going to attempt to get myself into a more idea body-fat content of 14-19%, perhaps less. I will probably have the surgery in March or April.

I have been keeping my skin healthy by taking nutritional supplements, moisturizing with cocoa butter oil and Vitamin E, etc. I do have many, many stech marks across my stomach and lower back, but my chest seems ok. I hope this will be enough!

I cannot imagine changing my lifestyle or "toning down" my weight loss for any time before the surgery in an effort to "stabilize" my body & skin. I will continue working out for the rest of my life, becoming more and more active, etc.. Maybe that isn't the point you're trying to get across, but I also know I cannot wait until I am at my "lowest" before I get the surgery. Now that I know what is possible, I cannot imagine going another summer with such a large chest!

I will try to post better photos based on your suggestions, Dr. Bermant.



As a side note for anyone else, I've been wearing synthetic (polyester) shirts that are "too small" for me so they give a snug fit. I've found they keep my chest pushed in and in-place similar to what I expect a gynecomastia vest would do, but at a much cheaper price. I picked them up from a local outdoor sports retail store I often shop at.. they have an online store if anyone's interested in the link.