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Hypothetical Surgery Scenario

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Hypothetical Surgery Scenario
« on: February 03, 2009, 04:44:42 AM »
What if an individual had only their gland removed during surgery. Would it, in theory, be possible for that individual to lose his remaining adipose tissue (fat) on his own accord afterwards?

Lets say, the patient is 15-20% body fat pre-op, and has the ability to get down to 7% body fat afterwards. Assuming there are no barriers to this fat loss, wouldn't this preclude his need for liposuction with the excision?

Thoughts?

Linkback: https://www.gynecomastia.org/smf/index.php?topic=16797.0

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Offline Grandpa Bambu

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Re: Hypothetical Surgery Scenario
« Reply #1 on: February 03, 2009, 08:02:53 AM »
For most, chest adipose tissue is very difficult, if not impossible to get rid of completely...

GB
Surgery: February 16, 2005. - Toronto, Ontario Canada.
Surgeon: Dr. John Craig Fielding   M.D.   F.R.C.S. (C) (416.766.8890)
Pre-Op/Post-Op Pics

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DrBermant

Re: Hypothetical Surgery Scenario
« Reply #2 on: February 03, 2009, 08:04:03 AM »
What if an individual had only their gland removed during surgery. Would it, in theory, be possible for that individual to lose his remaining adipose tissue (fat) on his own accord afterwards?

Lets say, the patient is 15-20% body fat pre-op, and has the ability to get down to 7% body fat afterwards. Assuming there are no barriers to this fat loss, wouldn't this preclude his need for liposuction with the excision?

Thoughts?


I advise my patients to get to a weight / body fat percentage they are comfortable with before considering surgery.  You can Calculate your BMI to see what is normal.  For those with too much body fat, Weight Loss Before Gynecomastia Surgery can help with the fat, but not the gland.  However, you cannot pick where your fat comes from.

Plastic Surgery is not a good jump start tool for weight loss.  I have seen disasters from patients from other doctors with deformities from significant weight loss after their surgery.  Men tend to put fat on first in the belly and chest bands.  We tend to take of those areas last.  Early surgery and depending on weight loss to predictably change the body is a major gamble.  No Surgery Body Shaping Garments are a better temporizing choice.

As a surgical sculptor, I view weight loss as a coarse tool and my plastic surgery as a refinement tool.  I prefer to use the coarse tool first, and then my sculpture for refinement.

For those having compromise surgery before (or without) weight loss, try to check out before and after pictures from many different angles.  Plastic Surgery is not an alternative to losing weight.  A fat person will still look like a fat person, just one with smaller breasts.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

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Offline BMB65

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Re: Hypothetical Surgery Scenario
« Reply #3 on: February 03, 2009, 11:45:04 AM »
What if an individual had only their gland removed during surgery. Would it, in theory, be possible for that individual to lose his remaining adipose tissue (fat) on his own accord afterwards?

Lets say, the patient is 15-20% body fat pre-op, and has the ability to get down to 7% body fat afterwards. Assuming there are no barriers to this fat loss, wouldn't this preclude his need for liposuction with the excision?

Thoughts?


I advise my patients to get to a weight / body fat percentage they are comfortable with before considering surgery.  You can Calculate your BMI to see what is normal.  For those with too much body fat, Weight Loss Before Gynecomastia Surgery can help with the fat, but not the gland.  However, you cannot pick where your fat comes from.

Plastic Surgery is not a good jump start tool for weight loss.  I have seen disasters from patients from other doctors with deformities from significant weight loss after their surgery.  Men tend to put fat on first in the belly and chest bands.  We tend to take of those areas last.  Early surgery and depending on weight loss to predictably change the body is a major gamble.  No Surgery Body Shaping Garments are a better temporizing choice.

As a surgical sculptor, I view weight loss as a coarse tool and my plastic surgery as a refinement tool.  I prefer to use the coarse tool first, and then my sculpture for refinement.

For those having compromise surgery before (or without) weight loss, try to check out before and after pictures from many different angles.  Plastic Surgery is not an alternative to losing weight.  A fat person will still look like a fat person, just one with smaller breasts.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

what kind of disasters do you speak of loosing weight after surgery ? ive lost weight in the past and get disgusted still having the moobs there ....they become more noticable and floppy which totally discourages loosing weight .....in my case (which i had extra weight before surgery) i was using the surgery as a major motivator to say to my self , now i can loose weight and it will pay off ! im post op by about 2 months , and have been hitting the weights pretty good and eating much better now .....im still in the healing process and def have loose skin leftover that looks bad but i have no regrets being that my curse is gone

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DrBermant

Re: Hypothetical Surgery Scenario
« Reply #4 on: February 03, 2009, 02:47:13 PM »
what kind of disasters do you speak of loosing weight after surgery ? ive lost weight in the past and get disgusted still having the moobs there ....they become more noticable and floppy which totally discourages loosing weight .....in my case (which i had extra weight before surgery) i was using the surgery as a major motivator to say to my self , now i can loose weight and it will pay off ! im post op by about 2 months , and have been hitting the weights pretty good and eating much better now .....im still in the healing process and def have loose skin leftover that looks bad but i have no regrets being that my curse is gone
The typical disasters I have seen have been patients of other doctors with chests lifted, further weight loss, and the nipples now back down well below the pectoral muscles.  Plastic surgery is a body contouring art form.  Dealing with the sagging tissues for many is part of the problem.  As an artist I prefer using a coarse tool first, and then the refinement.   Weight loss is the coarse tool.  Plastic Surgery is better for refinement.  Using the refinement tool first, then the coarse tool can leave distortions that more expensive revision may or may not be an option.  Patience helps.  For others, the issue is getting the weight off, the loose hanging tissues are secondary.  Bodybuilding can build muscles inflating loose tissues to a degree.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

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Re: Hypothetical Surgery Scenario
« Reply #5 on: February 03, 2009, 05:03:11 PM »
The reason I posted this is because I had my consultation with Dr. Haugrud in Calgary. After looking at me, he said he would only do excision, and that I don't need lipo. He very well may be correct. Other patients who have had Haugrud told me to trust his judgement. However, my only concern is whether I have more adipose tissue (fat) than he suspected; in this case, I may need to lose some excess visceral body fat post surgery - as he isn't removing any. I have a significant amount of muscle mass on my body, and I'd enjoy a lean pectoral region after the surgery. However, if there is considerable adipose tissue left behind during surgery, I wont attain this.

My gyne isn't overly bad aesthetically, however, it does cause considerable anguish. I'm fairly fit, and I imagine my body fat % is currently around 15%. I'm working on reducing it before surgery.

Re: Hypothetical Surgery Scenario
« Reply #6 on: February 03, 2009, 08:37:21 PM »
For most, chest adipose tissue is very difficult, if not impossible to get rid of completely...

GB

I can assure you that at a bodyfat percentage of <10%, most of it will be gone, regardless how stubborn it is.

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Offline Paa_Paw

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Re: Hypothetical Surgery Scenario
« Reply #7 on: February 03, 2009, 10:54:27 PM »
Weight loss, even to an unhealthy degree, will not rid you of Gynecomastia. In fact, Gynecomastia and even lactation were noted as being unusually common among starving prisoners rescued from various camps at the end of WW2.

That said, The Dr. is 100% right in his remarks. Carefully re-read the comments (above) by Dr. Bermant. He (and the other Drs. who contribute here) knows what he is talking about while the rest of us are often just guessing.
Grandpa Dan

Re: Hypothetical Surgery Scenario
« Reply #8 on: February 04, 2009, 10:25:32 AM »
Weight loss, even to an unhealthy degree, will not rid you of Gynecomastia. In fact, Gynecomastia and even lactation were noted as being unusually common among starving prisoners rescued from various camps at the end of WW2.

That said, The Dr. is 100% right in his remarks. Carefully re-read the comments (above) by Dr. Bermant. He (and the other Drs. who contribute here) knows what he is talking about while the rest of us are often just guessing.

I'm talking about the actual fat, not the breast tissue.

I've witnessed many cases where people have very feminine fat patterns. But, as they got <10% BF, it was not visible at all.


Also, lactation has nothing to do with gynecomastia. Lactated breasts are caused by increased PRL-levels.

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DrBermant

Re: Hypothetical Surgery Scenario
« Reply #9 on: February 04, 2009, 11:23:18 AM »
Weight loss, even to an unhealthy degree, will not rid you of Gynecomastia. In fact, Gynecomastia and even lactation were noted as being unusually common among starving prisoners rescued from various camps at the end of WW2.

That said, The Dr. is 100% right in his remarks. Carefully re-read the comments (above) by Dr. Bermant. He (and the other Drs. who contribute here) knows what he is talking about while the rest of us are often just guessing.

Thank you for your kind words.  Severe starvation damages the liver and its ability to metabolize the products of the body.  That is why there is gynecomastia and lactation issues.

Re: Hypothetical Surgery Scenario
« Reply #10 on: February 10, 2009, 10:29:22 AM »
What if an individual had only their gland removed during surgery. Would it, in theory, be possible for that individual to lose his remaining adipose tissue (fat) on his own accord afterwards?

Lets say, the patient is 15-20% body fat pre-op, and has the ability to get down to 7% body fat afterwards. Assuming there are no barriers to this fat loss, wouldn't this preclude his need for liposuction with the excision?

Thoughts?

While you definitely see some improvement in the chest region with a drop in body fat, due to shrinkage of fat cells in the chest, it's unlikely to preclude the need for liposuction, mainly because like may men with this condition, you have a higher distribution of fat cells in this area. Furthermore, trying to maintain this body fat % might be very difficult. The other benefit of liposuction in this case is  when gland is removed, you can feather the areas around it to ensure a smoother appearing contour.


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