Gynecomastia in the Massive Weight Loss Male
Gynecomastia is a relatively common occurrence in men. In most men with gynecomastia, there is a firm glandular tissue centered under the areola and varying amounts of fat. Typically in these men the skin tone is good and will retract very well with glandular excision and/or liposuction.
Men who have undergone significant weight loss are left with a not only excess breast and fatty tissue, but also skin. The skin tone is not good and stretch marks are relatively seen on physical exam. In addition to this, the position of their nipples is often low and makes the chest appear droopy. This is not unlike a woman who needs a breast lift.
In treating this type of gynecomastia, there are a set of extra issues that need to be discussed with the patient prior to surgery. First and foremost is the need for additional incisions, which means more scars. These are necessary to remove the excess skin in order to make the chest appear tighter. An open discussion needs to be had regarding the scars. Although scars are never invisible, they often do heal very well and for most men are more than a fair trade-off for correcting their chest shape.
Secondly, there is a higher chance of nipple sensation changes especially if a free nipple graft needs to be performed. In this scenario, the nipple and areola are removed at the beginning of the surgery, the excess skin and tissue are removed, and the nipple and areola are sutured back to the chest as a skin graft. In these cases there is also the risk of losing the color of the areola as well. These are all discussions that need to be had with the patient.
For most men who have undergone massive weight loss and are seeing a plastic surgeon for gynecomastia correction, the incisions are not a major deterrent as they have already undergone or at least considered body contouring for their loose abdominal skin and perhaps thighs. With the proper education and explanation, they can achieve the last phase of their weight loss journey: a contoured body.
To learn more about gynecomastia and to view before and after pictures visit my website at www.drdadvandplasticsurgery.com.