Possible gynecomastia?

[Sansui]

I've been overweight or fat almost my entire life, and even as a kid and in middle school I recall having a 'fat chest'.  Over the last couple of years (I'm 29 now) I've really gotten a handle on my lifestyle and made permanent, healthy changes.  At my heaviest I was 287, and I'm down to 187 right now.  The before/after pictures here are from 245 and 187 respectively - unfortunately I don't have the *really* fat pictures

My chest has gotten smaller as you can see, but I would have thought it would be even smaller at this point.  I'm at about 19.5% bodyfat, so I still have at least 15 pounds of pure fat to lose and I haven't started a weight training program yet (just pushups, cardio, squats, bodyweight exercises mostly)

Do you think this is mostly just a case of loose skin + remaining fat or could I have the gyne? :O

[Sansui]

"After Photos"

[DrBermant]

I've been overweight or fat almost my entire life, and even as a kid and in middle school I recall having a 'fat chest'.  Over the last couple of years (I'm 29 now) I've really gotten a handle on my lifestyle and made permanent, healthy changes.  At my heaviest I was 287, and I'm down to 187 right now.  The before/after pictures here are from 245 and 187 respectively - unfortunately I don't have the *really* fat pictures

My chest has gotten smaller as you can see, but I would have thought it would be even smaller at this point.  I'm at about 19.5% bodyfat, so I still have at least 15 pounds of pure fat to lose and I haven't started a weight training program yet (just pushups, cardio, squats, bodyweight exercises mostly)

Do you think this is mostly just a case of loose skin + remaining fat or could I have the gyne? :O

Congratulations on your weight loss!  Does it not feel much better with that weight off?  100 pounds is quite an achievement.  15 or more pounds of additional weight loss after surgery can be a factor after surgery compromising the result.

After Major Weight Loss skin and supporting tissues retract only so much leaving sagging and drooping.  These are usually global factors affecting most regions of the body.  For men, the sagging chest is often the biggest concern.  However, there are often issues of the stomach, thighs, buttocks, arms, and more.  While a Tummy Tuck Abdominoplasty can help with the front, a Lower Body Lift helps deal with the stomach, thighs, and buttock sagging. 

Low Nipples Do Not Look Good on the Male Chest.

Excess Skin of the Male Chest with Gynecomastia comes in various degrees.  Here are my Standard Pictures for Evaluating Extra Skin on the Male Chest.

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.
• 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.

For some patients, my small incision skin reduction chest lift is an option.  This eliminates the unnatural very obvious unnatural vertical scar.  For smaller problems, I have evolved my Internal Lift Male Mastopexy Surgery that has even smaller scars.  My internal lift is not suitable when the excess skin is a major contributing factor for the deformity.  A Male Donut Mastopexy when pushed too far will leave a star burst deformity that detracts from the result. That is why picking your surgeon carefully can be so important.

Yes, scars are a compromise.  We need some place to remove the excess skin.  The shorter the scars, the less skin that is removed. 

Options are best explored during an evaluation.

Hope this helps,

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

[headheldhigh01]

you definitely have it.  you can see the contours of an intermediate sized mass in the frontal picture, which along with the enlarged areolas are a dead giveaway.  you did well with the weight loss, you might be able to do just a little more before an op, and your case is advanced enough it'll never hide.  welcome to the site. 

[Sansui]

Doh, I kinda figured.  I guess either way, fat + skin or gynecomastia, I'd need a plastic surgeon.

I'm planning to continue losing fat until I get to about 12% bodyfat, as well as start a regular weight training program to build new muscle mass all over.  I'd like to be no more than 10-12% bf if I do end up going to a surgeon

[krucial]

i would do surgery at a moderate weight! not skinny and stuff... For my own weird reasons! of course

[fluffy_tits]

sansui how long did it take you to drop all that weight?  and what all did you do to drop as much as you did! 

and congrads on the weight loss!




Fluffy( o )v( o )...

[myth77]

congratz on the weight loss man, u look a lot better. Even though i do agree it looks like u have gynecomastia and surgery is the only way man =/

[Sansui]

sansui how long did it take you to drop all that weight?  and what all did you do to drop as much as you did! 

and congrads on the weight loss!

Fluffy( o )v( o )...

Hiya - I lost the weight in a couple different timeperiods actually.

In spring 2005, I weighed in at 287 and freaked out.  I went on a crash diet, started learning what foods to eat and avoid, and was running on treadmill 2 hours a day.  I lost about 60 pounds in 8 months.  Due to change of job and job stress, I started slowly putting it back on until I got to about 257.

In May 2008, I was at 257 and I'm now 187, so an average of less than a pound a week over last 19 months.  This time around I've tried to make it a sustainable lifestyle change, and I feel that is has really worked.  The things I've done include:

• Keep a food journal every day to ensure you stay on calorie targets
• Weight myself every week, and if I've gained a pound or two make sure I get back on track quickly
• Exercise at least 2-3 times a week
• Replace white flour products, like white bread, with whole grain equivalents.  Wheat bread with no corn syrup!
• Drink soda, even diet soda, very rarely - 2-3 times per month - water is best for hydration
• Drink alchol very rarely - usually I'll have 6-8 drinks at a party a few times a year
• Eat fast food very rarely - 2 times per month
• Measure out portions for meals so that you can accurately record calories in your diary, plus it keeps you from overeating
• Eat frequently throughout the day, and make main meals smaller
• Prepare more meals at home
• Have a number of 'go to' snacks - like fat free yogurt, string cheese, unsalted pretzels, roasted almonds, apples, kashi chewy bars, south beach protein bars, blueberry green tea, etc

The great thing is that even though I 'fail' all the time, like if I'm sick in a week, I might drink a lot of soda and miss all my workouts and everything, my body has readjusted from my old ways and I actually crave the things that will put me on track again.  My body *wants* to eat small meals.  It *wants* to get exercise if I've been cooped up all week.  It *doesn't* want refined carbohydrates and sweets that I used to constantly crave.

I used to think I would never be able to overcome the sugar addiction, but after retraining my body over this period of time, it makes me ill to eat too much sugar or too much fatty food. I feel like I finally have normal physical responses to food consumption now.  I haven't felt like I've been on a diet for almost the last year.  It just feels like I'm living normally and the weight still comes off.  I'm a much happier person My girlfriend doesn't mind the man boobs, and I feel like I have a very positive self image, but I've hated the moobs too long to just let them have a free ride now that I'm nearing my goal weight and getting ready to start weight training!

[johnny125]

I agree with the doc. Your biggest problem is the loose sagging skin. You will look better after surgery for that.