Author Topic: Gynecomastia Forum - Global Fat Loose Skin Tightening Needed?  (Read 6888 times)

Offline DrBermant

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Gynecomastia Forum - Global Fat Loose Skin Tightening Needed?
« on: November 20, 2011, 02:38:52 AM »
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Hi DrBermant,
 
Thanks for your reply.

I am 28 years old from Mumbai, India. I have gynecomastia since i was 12. Recently on 8th Nov 2011 i had visited a plastic surgeon who is known gynecomatia doctor. After checkup he told me that he perform excision, liposuction & skin tightening on me. He told that my gland size is big enough & my weight is not constant so skin tightening is must. But i am pretty doubtfull on skin tightening as this required on very severe cases & i think mine is not so severe.Might be he may be correct in order to avoid carter deformation or any skin loosening effect in future.
My details:
Weight: 68 kg (+/- 3-4 kg quick weight fluctuations)
Height: 5.8 ft
Skin type: Loose & soft than normal man skin

I have attached my recent pics.Please have a look & let me know the best surgery procedure to be performed on me.
Dr. Bermant your feedback will be very much valuable to me.

--
Regards,

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon. Since I am no longer practicing medicine, I no longer offer specific advice for medical care. General issues are still important factors.

Have you checked out your BMI Calculator (Body Mass Index)? Unfortunately, BMI does not take into account bone, muscle mass, vs. fat.  Body Fat Analyzers can help define that issue.

If there is a global fat component to a problem, surgery is not the best place to start. Weight Loss Before Gynecomastia Surgery is usually much better than weight loss after surgery. As a Surgical Sculptor I preferred to use a coarse tool first, then one of refinement. Weight loss is a coarse tool, Plastic Surgery is better reserved for refinement.

If there is a global fat component and weight loss indicated, loose skin may become a factor. That is best defined before the operation than having a secondary problem after surgery followed by weight loss and residual contour deformity from fat and loose skin.

If there is a loose skin component, Standard Pictures for Male Chest and Loose Skin are a better way to define this issue than just photos standing upright. Unless there is such a major Loose Skin Component on a Male Chest, skin reduction scars are something I preferred to avoid when I was practicing surgery.

Here is a forum discussion about Puffy Nipple Skin Reduction Not Needed. Here is another discussion about Skin Reduction Gynecomastia.

Any surgeon advocating a skin reduction for a particular variant of gynecomastia should be able to demonstrate their results using the standard pictures, or even better yet, Standard Videos to show how tissues look on movement and bending.

Avoiding a Crater Deformity takes careful surgeon selection. Check out my new resource on How to Pick A Gynecomastia Surgeon.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia Male Breast Reduction
Michael Bermant, MD
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Offline Gyne28

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Re: Gynecomastia Forum - Global Fat Loose Skin Tightening Needed?
« Reply #1 on: December 10, 2011, 02:08:17 PM »
Thanks for reply Dr. Bermant. I have shown my cases to three doctors & i found different opinions from them. Please let me know your opinion.

Link of doctors opinion:

newbielink:https://picasaweb.google.com/108932037909716939321/SurgeryProceduresFromDoctors?authkey=Gv1sRgCKyqpuL6_dD0Xw [nonactive]


My  pics:

newbielink:https://picasaweb.google.com/108932037909716939321/PreOperation?authkey=Gv1sRgCOXx5KaJ0P-s-wE [nonactive]


Regards,
SA

Offline DrBermant

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Re: Gynecomastia Forum - Global Fat Loose Skin Tightening Needed?
« Reply #2 on: December 11, 2011, 02:24:03 AM »
Thanks for reply Dr. Bermant. I have shown my cases to three doctors & i found different opinions from them. Please let me know your opinion.

Link of doctors opinion:

https://picasaweb.google.com/108932037909716939321/SurgeryProceduresFromDoctors?authkey=Gv1sRgCKyqpuL6_dD0Xw


My  pics:

https://picasaweb.google.com/108932037909716939321/PreOperation?authkey=Gv1sRgCOXx5KaJ0P-s-wE


Regards,
SA

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Welcome to our forum and thank you for posting your pictures and diagrams of techniques suggested.

You can find an extended discussion about Liposuction then Possible Excision What Order Parts of Surgery? discussed here on this forum. Take your time to explore each link to better understand the real rational and demonstration with pictures and videos behind the answer. None of the drawings you link to discuss a skin reduction method.

I already offered the resource How to Pick Your Gynecomastia Surgeon which also can take some time to absorb the extended detail. But the critical factor here is looking at actual results to document a particular claim by the doctor. Unless you take care and are careful in How to Evaluate Gynecomastia Pictures, you may get lucky. Unfortunately I saw so many unhappy patients after misadventures done by other doctors. Many admitted they just did not look for just what that doctor offered before having surgery: a formula for disaster.

In your images listed, you are severely lacking many critical views I used when helping my patients in the past. Just a few photos just does not tell the complete story about the problem nor what was done with surgery. In particular for the evaluation of the remote scars, you really need to see how the tissues move with arms up overhead  and flexing muscles images. The videos are more critical. Beyond that you have not indicated your body fat percentage the Body Fat Analysis that are essential factors to understand if the contour has a global fat component. Ignoring such details could result in a compromise result as discussed above. Just looking a drawings demonstrating method are a major gamble in assessing a surgeon's claims of technique.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction
Michael Bermant, MD
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Offline Gyne28

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Re: Gynecomastia Forum - Global Fat Loose Skin Tightening Needed?
« Reply #3 on: December 11, 2011, 11:42:07 AM »
Dr Bermant, i am sorry for not providing detail pictures.
Here are the detail inputs of my gynecomastia:-

My Video:-
newbielink:http://www.youtube.com/watch?v=mVAIvhPEXXA&feature=youtu.be [nonactive]

My Pics:-
newbielink:https://picasaweb.google.com/108932037909716939321/PreOperation?authkey=Gv1sRgCOXx5KaJ0P-s-wE [nonactive]

Doctors Surgery methods:-
newbielink:https://picasaweb.google.com/108932037909716939321/SurgeryProceduresFromDoctors?authkey=Gv1sRgCKyqpuL6_dD0Xw [nonactive]

Offline DrBermant

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Re: Gynecomastia Forum - Global Fat Loose Skin Tightening Needed?
« Reply #4 on: December 11, 2011, 11:57:28 AM »
Dr Bermant, i am sorry for not providing detail pictures.
Here are the detail inputs of my gynecomastia:-

My Video:-
http://www.youtube.com/watch?v=mVAIvhPEXXA&feature=youtu.be

My Pics:-
https://picasaweb.google.com/108932037909716939321/PreOperation?authkey=Gv1sRgCOXx5KaJ0P-s-wE

Doctors Surgery methods:-
https://picasaweb.google.com/108932037909716939321/SurgeryProceduresFromDoctors?authkey=Gv1sRgCKyqpuL6_dD0Xw


This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Thank you for posting the additional images. They are quite revealing. A complete picture is best established during a consultation where I had my patients complete detailed history forms giving me critical information to better understand the problem and concerns of my patients. With the images / video, I was able to offer specific recommendations during a Preliminary Remote Discussion that still needed to be supplemented with a confirmatory in office examination. This process approached a 99% correct assessment that we were able to proceed with the tentatively scheduled surgery the next day.

I have retired and thus do not offer such specific advice nor options. From the limited details provided, it certainly looks like you would be getting my discussion about considering weight loss first as mentioned in the first post in this thread. When there are global fat contributions to the contour, surgery is a compromise. Breasts can be made smaller, but the global remaining fat will still look like a breast.  Here is one such example of Compromise Gynecomastia Surgery on someone who did not want to lose weight first.

Again we are getting back to looking at real pictures and results behind a doctor's claim of method. Look to see just what their techniques offer you by looking a pictures done on similar body types. That is an issue on some discussion location on the internet where links to proof, images, and details are discouraged so that verbal hand waiving can replace detailed proof.

Body Shaping Garments have proven to be a great temporizing option for my patients in the past who wanted a better contour while they were losing weight. The images there demonstrate the degree contouring occurs on different body types. Check the entire spectrum of the proof to understand its value and limitations. Here is the link to Stage 2 Male Compression Vest so many of my patients used.

Good luck on your education efforts and new contours. Be careful before jumping into something that you then regret not being more careful.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction
Michael Bermant, MD
Retired Plastic Surgeon
Surgical Sculptor, Artist, Creative Thinker, Problem Solver
Plastic Surgery
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