Breast Gallery

A man in his late 50’s who had a gastric sleeve performed endoscopically by the bariatric service 3 years before and reduced his weight from 385 to his present weight of 257. He is 5’9”. He was bothered by a feminine appearing chest and hanging skin
of his arms. He is shown before and again, 11 months after bilateral brachioplasty and bilateral gynecomastia excision with free nipple grafting.

Details: 210 gms of skin were excised from his right arm and 224 gms from his left are. 920 gms of breast tissue were excised from his right breast, and 918 gms from his left breast, and 400 ml of fat was aspirated from his right breast and chest, with 400 ml of fat also being aspirated from his left chest. An accurate placement and size of the new nipple is critical, and
The diameter of the nipple
was made at 25mm, and the new placement of the nipples was marked with the new nipple plane located 0.33 times the distance from the sternal notch to the pubis, and the internipple distance being 0.23 times the chest
circumference.

Discussion: Studies show that the risk of infection and wound healing complications increases above a BMI of and with His BMI of 37.67 we can expect a nearly 3 fold increase in these issues. As expected, he had small areas of skin separation and infection that delayed his healing, and we can see some inconsistent healing of his free nipple grafts. Scars will typically continue to fade and improve in the arm area after brachioplasty for 3 years. Despite this he
now has a normal chest and arm contour and is comfortable wearing fitted shirts. Although gynecomastia surgery in patients with lax skin trades a visible chest scar for an improved contour, he feels comfortable now taking his shirt off
at the beach. Having a hairy chest and some slight looseness of the skin helps to camouflage the scars better.