Surgical treatment for gynecomastia in overweight and/or obese men or after massive weight loss

Massive weight loss and its effect on the chest area

male breast enlargement after weight loss - pic

Gynecomastia after weight loss

Massive weight loss through either dieting or bypass surgery addresses one issue but may result in another. While overall body fat is reduced, the skin around the chest area may remain problematic. Stretch marks are common, and surplus skin will have lost most of its elasticity, preventing it from returning to normal. The once large breasts are now deflated, sagging and drooping downward.

Treatment options for gynecomastia after massive weight loss

image skin removal and free nipple graft at 3 weeks post op

Skin removal and free nipple graft at 3 weeks post op

After massive weight loss, the breast fat has all but disappeared; however the male breast gland without fat or very little fat still remains.

The male breast reduction in this instance is different than that of typical gynecomastia. The remaining skin, which has been stretched to the extreme, is tightened and the nipple and areola are moved up. In some cases, they are removed and reattached as a free nipple graft one the excess skin has been removed. Nipple sensation however, is lost. You can see the excellent results in this gynecomastia case.

Two-stage procedure

The severity of the case determines which surgery technique will be used. In some cases a two-stage procedure is the better option to minimize the amount of scarring. For most however, a more aggressive approach may be needed, requiring longer incisions, similar to a mastectomy. Keep in mind though; the scars will fade with time.

Gynecomastia in overweight or obese men

The overweight or obese man has a tremendous burden to carry. Not only are there significant physical health issues associated with obesity, but the resulting gynecomastia can have a considerable emotional impact on daily life as well.

Concealing the chest in clothing can become challenging. The female like appearance of the chest may be embarrassing. While the abdomen and flanks are usually large as well, this does not carry the same stigma. Self-confidence can be deeply affected.

Weight Gain and its effect on the chest area

male patient with weight gain - photo

As a man gains weight, the male genetics marker triggers fat accumulation in the chest, abdomen and flanks. Even if the weight is lost, these same areas experience less fat loss.

Excessive weight gain increases both fat and breast gland tissue in the chest. With the increases in fat tissue come increases in estrogen levels, triggering additional breast development.

Treatment options

A man who is overweight or obese may have pseudo-gynecomastia due to fat only or true gynecomastia with excess fat.

First line treatment is weight loss, but this can be very difficult and may not solve the entire problem. Bypass surgery is an option but can be very expensive, and some insurance companies may or may not cover this procedure.

Corrective surgical treatment for an overweight or obese man is also an option. The procedure is similar to that performed when massive weight loss is the cause; however in this instance, the fat component needs to be addressed.

male breast enlargement in the overweight patient - photo

Gynecomastia in the overweight patient

after male breast reduction treatment and liposuction - photo

After surgical treatment for gynecomastia and liposuction

Remember, every case is unique to the individual, and it's important for the surgeon and patient to discuss all of the pros and cons of corrective surgery.

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