Gynecomastia surgery after weight loss requires the expertise of a board certified gynecomastia specialist. There can be a large amount of skin, fat, and tissue after weight loss that requires special skills for reduction beyond the traditional male breast reduction surgery.
For some men, the 2 stage procedure is an excellent solution to remaining tissue and skin after weight loss. The first stage reduces the amount of skin and tissue by an excision in a doughnut shape around the areola and then closed with purse string type sutures. The second stage can be done as an office procedure under local anesthesia. See our blog on April 16, 2012, for more details on the 2 Stage Procedure.
The 2 stage procedure is not an option for some men with excessive amounts of skin to be removed. In order to get a more masculine chest, the surgeon will need to make incisions around the areola, and vertical to the breast crease, known as an inverted T or the anchor incision. This incision will leave visible scars, but most men are comfortable with the trade-off.
Unless the patient is prone to keloids or developing raised scars, the incision heals nicely. However, for those who end up with more visible scarring, there are several treatments today that can minimize the final result. The skilled gynecomastia surgeon will use deep suturing techniques to reduce tension on the skin.
Silicone sheeting has proved to be a good treatment once the incision has healed by keeping the skin hydrated. Steroid injections, massaging, and laser treatments are all possible treatments. For the most difficult scars, scar revision surgery may be needed.