Q: Dr. Eppley, I am interested in having an abdominoplasty performed. But a a little history…I was overweight my entire childhood, finally reaching 320 lbs by late 2011. I made some big changes and lost most of the weight very quickly, about 90 pounds in the first year. I have been hovering around 190 lbs for over a year now and am generally happy with my weight. I have completely changed my diet and know I will never go back to my old ways. The only evidence of my former self resides in my chest, stomach, and inner thighs. There is some loose skin on my upper arms as well, but I’m not too concerned with that. I’ve attached some pictures to get your opinion. What kind of procedure do you think would be best for me?
A: From an abdominal standpoint, the roll of excess skin goes all around the waistline so a tummy tuck must be a near circumferential technique to really get all the excess skin out. Male tummy tucks are unique because they never require muscle tightening since there is no rectus diastasis from prior pregnancies. So it is essentially getting out all the loose skin and that probably encompasses at least a ‘300 degree’ excision length. The chest is always the most challenging in any male weight loss patient due to the skin and nipple sag and the inability to tolerate the scar locations from traditional breast lifting procedures that women undergo. (since they are being left with a breast mound while men want the chest flat) In my experience, all such chest reshaping procedures in many male weight loss patients leave me wanting for better results than they often produce, but the key is to not have any procedure that leaves with the trade-off of unsightly scars. In your case, I would recommend a periareolar reduction technique with liposuction. Whether any more than that would be indicated would require a true frontal picture so I can better assess what degree of chest sagging you have. (your current chest picture is taken from below and that may make it look less saggy that it really is)
Dr. Barry Eppley