The best procedure for a my severe case of gynecomastia (Pictures included)?
I have lost a decent amount of weight a long time ago, and have excess skin as a result. More recently though, I have put some of that weight back on . Given my current status:
1) What would be the best procedure for me to achieve the best possible aesthetic outcome.
I am not particularly perturbed by scars (assuming a mastectomy is required) as I plan on getting a tattoo for a cover up.
2) Do I need to lose more weight prior to the surgery?
Really appreciate your time and effort in answering the above. Also, if there are any Melbourne surgeons who have done a similar surgery before , do let me know and I would love to pop in for a consult. Thanks!
Thank you for reaching out to us here at Ask ASAPS. My name is Dr Gary Avery and I am a Specialist Plastic Surgeon.
In answer to your queries I suggest:
1. A male breast reduction will remove the breast tissue and give you the flatter, more contoured chest. A suitable option for you would leave a scar at the lower part of breast, essentially where the skin forms a fold that the breast above this hangs over. Along with this the nipples are removed and replaced; – this is called a nipple graft – to ensure that the nipples are in the correct position for a male. Surgery would take about three hours in theatre and you would remain in hospital for a day or two to recover.
2. Being at your goal weight is always my suggestion as it gives you more longevity out of your results. Should you go on to lose more weight following surgery, you may be left with excess skin in the chest area which may require further surgery down the track. Given the investment in surgery and the time to recover, it is best to be starting with you being at a weight that is maintainable and something you are happy with for the long term.
There are lots of great surgeons in Melbourne, so I recommend taking a look at the surgeon listing on the ASAPS site and seeing who you connect with.
All the best,
Dr Gary Avery
Hi Navin. It is best to be at your lowest maintainable weight before planning surgery. Your breast needs to be loose and moveable, if it is stiff and solid, it is hard to improve. Your gynaecomastia has given you a large nipple that sits low and lateral, a moderate amount of what looks to be fatty breast and a significant breast tail that extends around your lateral chest. All three would need to be addressed. The breast looks like it will need to be excised, thinned out and the nipple grafted back on as a smaller version. It may be possible to improve the lateral chest with liposuction but this may lead to baggy skin. The best solution is to continue the breast excision scar which runs from near the midline along the fold under the breast further, vertically up to the armpit. This crescent excision is effective in dealing with breast excess and the lateral chest excess. Scar quality can be variable in the horizontal component as the chest isn't a good place to put a scar but the vertical scar extension is usually quite reasonable. All the best, Dr Alastair Taylor