Following gynecomastia surgery, so many men look just terrific – their chests appear masculine and sculpted with virtually no trace of scars. Patients who are considered “ideal” start out with a variety of advantages: most are relatively trim; many have youth and/or good skin quality on their side.
But what if you don’t have those advantages? What if you’re an overweight or formerly overweight guy with extra skin to deal with, and maybe not so young? Can you still benefit from gynecomastia surgery?
The answer is “yes,” with a few considerations:

  • It is critical that you and your plastic surgeon communicate clearly and decide on the right surgical strategy together. When skin may need to be removed as well as breast tissue and fat, surgery is more complex and there are more options to consider.
  • If you and your surgeon discuss removing redundant skin, you will need to think about whether the scars are likely to be acceptable to you. This “scar tradeoff” decision comes up in every procedure where skin is removed – you’ll be trading a slimmer, sleeker silhouette for inevitable scars on your chest.

Here are some examples of approaches we use for gynecomastia surgery for New York patients who are heavy or formerly obese:

  • Minimal scar surgery with a possible second procedure: Guys who are overweight with breasts that droop slightly often elect to have the normal minimal scar surgery. This involves small incisions around the areola for gland removal and nicks on the side of the chest for liposuction. During the few months post-op, we wait to see how well the skin tightens over the re-contoured chest.
  • The second-stage surgery: When this first set of patients opts for skin removal after minimal scar surgery, we often perform a “wing mastopexy.” This procedure elevates the nipple and removes redundant skin to the side of the nipple through small horizontal incisions.
  • Mastectomy and reconstruction: Men who have very droopy breasts often get the best result when we re-position the nipple higher up on the breast and excise gland and fat and skin. For this procedure, incisions are required around the nipple and in the fold below the breasts.

There are two important keys to gynecomastia surgery success for men with extra skin. One is selecting the right plastic surgeon, which may require traveling. In this case, you need to find someone with a wealth of experience treating gynecomastia for all kinds of patients. A doctor who performs male breast reduction on occasion is probably not the best choice.
The other critical success factor is an effective consultation appointment with your plastic surgeon. Bring a list of questions and a notebook for capturing information. Make sure you understand completely where your scars will be placed and how big they will be. Also, ask to see plenty of before and after gynecomastia surgery photos of guys who have had the procedure you’re considering.
Don’t hesitate to take the plunge and schedule a consultation. The purpose of the appointment is an information exchange. You may decide male breast reduction is right for you, or you may choose to forgo surgery. Either way, you will be making an informed choice.

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