Gynecomastia Reduction is one of the most frequently performed cosmetic plastic surgery procedures for men. Over the last 20 years, the number of Gynecomastia Reductions performed has increased 50% – from twenty-thousand in the year 2000 to thirty-thousand procedures last year. However, the examples I am sharing today are not your typical gynecomastia reductions.
Gynecomastia Reduction after Massive Weight Loss is a different operation than the typical gynecomastia reduction. The large amount of excess skin and extremely low nipple position require special attention to detail and appropriate treatment to achieve a great result. This patient had chest skin reduction (a male breast lift), reduction and repositioning of his nipples along with a tummy tuck to restore his physique after impressive weight loss.
Types of Gynecomastia Reductions
Male Breast Reduction techniques vary depending on the amount of tissue that needs to be removed. Small lumps of firm glandular tissue located beneath the nipple/areola complex (NAC) can be excised directly via a small incision around the edge of the areolae. Large reductions may also require liposuction to remove excess fat (aka pseudogynecomastia). Gynecomastia reduction associated with loose skin, or sagging nipples, is more challenging and is the topic of today’s Massive Gynecomastia Reduction Video. This situation is most commonly seen after large weight loss from either Bariatric Surgery or a change in lifestyle resulting in massive weight loss.
Massive Gynecomastia Reduction Video
The following Plastic Surgery Video Presentation shows several methods of Extreme Gynecomastia Reduction. These are common Post-Bariatric Plastic Surgery techniques, but are not the most common methods used for routine Male Breast Reduction. This segment is taken from my TV show Body Beautiful which airs on the San Francisco Bay Area’s News Station, KRON 4.
Post-Bariatric Male Chest Reduction with Tummy Tuck
The goal of Bariatric Surgery is weight loss and the health improvements that come along with it. The improvement, and sometimes the resolution, of diabetes and high blood pressure are frequently seen after weight loss.
On the other hand, massive weight loss also usually leaves behind a large amount of excess skin, and this continues to makes it difficult for patients to feel comfortable. Even with the loss of mass, redundant skin makes finding clothes that are flattering and which fit well difficult.
A massive amount of excess skin is apparent on the trunk of the patient below. His chest is deflated and overhangs laterally, and even in clothes, it looks like he has breasts. His abdominal skin excess is uncomfortable and a nuisance, especially at the belt-line.
Body Lift after massive weight loss including: chest reduction (massive gynecomastia reduction), areolar reduction, breast lift and abdominoplasty (tummy tuck). The early scars are more noticeable in the first several weeks to months after surgery, but will continue to improve and fade during the year or two after surgery.
A combination of Gynecomastia Reduction with skin excision and a Tummy Tuck was used to redefine his trunk. The scars beneath his chest are still healing and will fade with time. There is another scar running below the belt-line which allowed for the tightening of his abdominal muscles and removal of his skin laxity. When loose skin extends all the way around the waist, a Lower Body Lift is often the procedure of choice.
Gynecomastia Reduction Revision Surgery
Gynecomastia Reduction Revision Surgery is perhaps the most challenging of all Gynecomastia surgery. In the case below, the patient complained of still having breast fullness after a previous Male Breast Reduction. He had bottoming out of his chest skin resulting in the appearance of breasts in clothing. Paradoxically, he also has severe indentation of his nipples from the previous resection. This can happen when a large amount of breast tissue is removed.
The patient shown below was treated with skin excision and restoration of volume beneath his nipples to smooth his contour both in and out of clothing. Like the patient above, he has scars located beneath the breasts, but these have faded over time.
This patient had gynecomastia surgery prior to presenting to my office. Revision gynecomastia surgery was performed including restoration of volume beneath the nipples (left > right) and resection of the excess skin that remained along the lower chest. His scars have had time to heal and are less noticeable; however, individual results will vary.
Gynecomastia surgery can be rewarding and build self confidence. Prior to surgery, his sunburn was confined to the open collar area of his chest. After surgery, he was confident in his appearance and went shirtless. The unfortunate result was a burn to his entire chest. He got the sunscreen lecture, but I was also happy that he finally felt comfortable in his own skin.
You have heard it before and will hear it here again on the San Francisco Plastic Surgery Blog. Use of appropriate sun protection is recommended to help prevent skin cancer and premature aging of the skin. In the postoperative period, sun protection is especially important to help prevent the scars from tanning, turning dark and becoming more noticeable.
Breast Reduction for Men Consultations
As mentioned previously, the type of Male Breast Reduction shown above is usually only necessary after massive weight loss. There are exceptions, however, and I have had to perform this surgical variation for men after hormone therapy for prostate cancer and also for a gentleman whose breast enlarged massively with CoolSculpting®. Though rare, Paradoxical Adipose Hyperplasia (PAH) after CoolSculpting® is definitely not cool.
If you count yourself among the 33% of men who continue to have Gynecomastia after puberty, and you would like to learn exactly what treatment options are available for you, call (925) 943-6353 today, to schedule a private consultation appointment. You can also submit your questions via the contact form on this page.
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