“Dr. Polo, I’ve lost a lot of weight and now I have lots of excess skin and my chest is sagging severely. What can you do to help me, so that I’m more comfortable wearing T-shirts or even having my shirt off?”
Previously in this column, I discussed management of gynecomastia, or male breast enlargement. Options for that condition generally include liposuction, excision of glandular breast tissue under the nipple, or a combination of those two techniques. A related, but somewhat different condition that men sometimes face, is severe sagging, or ptosis, of the breasts. This condition is very common in women, regularly occurring after multiple childbirths and breastfeeding. In both women and men, breast ptosis commonly occurs after large weight loss.
Although there is an epidemic of obesity in the U.S., a large number of affected individuals these days succeed in reversing their condition, either through lifestyle changes or through surgical intervention. This is a tremendous accomplishment for these people; however, it does come with some new challenges. I am so grateful in my practice to have the opportunity to help these patients continue their journey toward a healthier physical and psychological self, through body contouring surgery.
For men who have achieved large weight loss and are seeking body contouring procedures, the priority is to assure that they are in an acceptable state of health to undergo surgery. This includes having a stable weight and good nutritional status. Once a BMI under 30 has been reached and there is no ongoing weight loss, it should be acceptable to proceed with body contouring surgery. A patient’s nutritional status is also important. Proteins and vitamins are essential for healing, and the body’s reserves and ability to absorb these nutrients are crucial for healing complex surgical wounds.
Body contouring after large weight loss may be indicated to address excess skin of the face and neck, the chest/breasts, the abdomen and back, or of the arms and thighs. Male breast lift surgery involves tailoring of excess skin, and sometimes liposuction for reduction and contouring of any residual fat. The skin tailoring always involves an incision around the entire periphery of the areola. For patients with only a moderate amount of skin excess and breast sagging, a donut shaped area of skin can be removed from the center of the breast and the nipple and areola can be reduced and lifted to a slightly higher position. With a larger amount of redundant skin and breast sagging, an incision along the fold beneath the breast is also required to remove excess skin at the lower part of the breast and sometimes extending along the lateral chest as well.
This procedure improves overall chest aesthetics by reducing breast volume, removing excess skin, lifting the nipple and areola to a higher position and sculpting a more youthful and masculine shape. As with other body contouring procedures, combined with the previous weight loss, these results contribute significantly toward improving self-esteem and quality of life.
If you’re unhappy with a sagging chest after weight loss or any other cause, consult with a plastic surgeon, certified by the American Board of Plastic Surgery, to find out how to reach your goals.
Dr. Polo is a graduate of the University of Miami, Miller School of Medicine. He is a board-certified Plastic Surgeon and partner at Miami Plastic Surgery. He has been in practice over 20 years during which time he has remained an active member of the medical staffs of Baptist Hospital and South Miami Hospital. Dr Polo is dedicated to patient safety and education in Plastic Surgery, and he has been recognized by his peers by election to leadership positions including past-president of The Miami Society of Plastic Surgeons and president-elect of the Florida Society of Plastic Surgeons. Dr. Polo is an expert in Cosmetic Surgery of the face, neck, breasts and body. His greatest expertise is in breast augmentation and mommy makeovers. His practice also encompasses the entire spectrum of non-invasive treatments such as Botox, fillers, CoolSculpting, ultrasound, lasers and radio-frequency.
Dr. Polo’s favorite spots on the island include the Crandon Park golf course, the beach at Cape Florida Light, and The Spa and Rum Bar at the Ritz Carlton.
You can email him questions at mpolo@miamiplasticsurgery.com.
To read Dr. Polo's last column, click here.
