Gynecomastia after weight loss

gynecomastia after loosing weightMen account for 15-20% of the total number of patients who undergo stomach surgery to lose weight and theoretically this number is increasing. The number of gynecomastia cases increased by 22% from 2005 to 2006. The most common deformity in these men is the excessively loose chest skin after weight loss.

Glandular gynecomastia occurs in older men while pseudo-gynecomastia is characterized by an increase of the subcutaneous fat in the breast without necessarily an enlargement of the gland. The diagnosis, done with palpation, differentiates the glandular differentiates the glandular gynecomastia which appears as a circular area beneath the areola from the latter in which a diffuse fat deposition appears.

There are several methods for the treatment of gynecomastia after weight loss depending on its classification.

Classification and therapeutic algorithm of pseudo-gynaikomastias after weight loss.

Class Description Treatment
Ι slightly loose skin without influencing the areola  liposuction or Webster type removal
without side skin
with side skin
liposuction or Webster type removal
II the areola is below the submammary line, side skin
mildly loose skin in the upper abdomen
inner skin removal and Webster type resection. Stitching in the outline of the areola.
ΙΙΙ the areola is well below the submammary line and there is side skin relaxation  

skin removal and replacement of the areola as a free graft


Class Ia without loose skin

Class Ib with loose skin

Class II with the areola below the submammary fold

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Class III with significant skin relaxation