Men Get Body Contouring Surgery After WLS Too!

August 20, 2018

In 2016, men accounted for 13.8% of plastic surgery patients with 3,264,254 procedures performed worldwide. The top five procedures requested by men are Eyelid Surgery, Gynecomastia, Rhinoplasty, Liposuction and Hair Transplant. (ISAPS statistics 2016). The trend of plastic  surgery for men is growing and especially for men that have had weight loss surgery or experienced a massive weight loss.

The AWL procedures with the highest growth rate were: Lower Body Lift (29%), Upper Body lift (26%), Buttocks Lift (20%), however the percentage that represents male patients is unknown.

Plastic Surgery For Men

Today we are seeing a continuous growth rate in men interested in having plastic surgery as well as non-surgical procedures. Men believe (and rightfully so) that their appearance has a direct impact on their careers and enhancing their looks makes them feel better and they are more confident within themselves.

After weight loss things change, it is no longer about just wanting to look better. It turns more to seeking well-being, wearing attractive clothes that fits their body better, avoid or prevent extra-skin dermatological issues as are dermatitis, skin infections, odor, etc., being able to do all types of exercise without having skin flapping issues, and of course, to enjoy and feel comfortable and attractive in beach or pool attire!

After weight loss in male patients, whichever way achieved, be it self-effort or bariatric surgery, male patients develop flaccid tissues completely different in comparison with women.

I have observed through my 15 years of practice that male patients seem to lose weight more frequently on their own and maintain their weight better in comparison with women. Once men have achieved healthier eating habits and a daily exercise program these habits tend to remain for life.

After my bariatric surgery in 2012, I remained stable for only 3-4 years and then I started regaining weight. I had to go back to my “New” habits I learned from my Gastric Sleeve: eating smaller amounts more frequently and slower, chewing food better, have snacks in between meals and very importantly going to the gym with a diligent exercise program. There are No miracles. Most important, male or female, we must all make these healthy habits our new lifestyle!

Differences Between Males and Females

Quality of skin: Male tissues are naturally tighter, thicker and have less tendency to develop stretch marks, or extreme flaccidity unless the loss is extreme (more than 40% of their weight). Also, their tissues are less prone to develop an infection in comparison with women. (Plastic, Reconstructive Surgery Glob Open 2016;4: e1030, Aesthetic Surgery Journal. 37(1):89-99, January 2017).

The bone frame: Male body frames are different, showing wide shoulders, bigger chest structure, narrow hips.

Muscle frame: Males develop more muscular volume on arms, chest, back, and less on gluteal muscle, thighs, and calves unless, of course, they work out hard enough to cause hypertrophy and may acquire large muscle volume all over.

Fat distribution:  The male percentage of fat is lower in comparison with women. Amongst men, it is frequent to see fat in love handles, abdomen and some on the chest.

Most Common Post-Op Weight Loss Surgeries For Male Patients

Arm Lift

Skin resection of the arms from the armpit to the elbow (before or beyond this point depends on the severity of the case) with an incision placed where the patient will not see it himself.

Gynecomasty/Male Reduction of Chest

There are mainly 3 degrees of gynecomastia (excess of mammary tissue in combination with an excess of fat and or skin)

1. Only the nipple/areola is protruding and will only need the minor mammary gland resection through a half-areola incision.
2. Volume reaches 3-5 cm above the nipple/areola complex or even below (rounder lower pole) will need the combination of liposuction to remove the majority of fat to flatten the area, and also mammary gland resection. Incision: half-areola incision.
3. Volume is bigger and often with a certain degree of flaccid tissue similar to the female breast shape. Treatment will be the combination of the Mammary gland and skin resection through a horizontal incision over the new inframammary fold. This procedure is considered a Chest Masculinization.

Lateral Chest Torsoplasty

The lateral torso is a particularly difficult area to treat because it is not an extension of the arm or breast area. No arm lift or Chest Masculinization would be the treatment for this area.

This area is better enhanced to tighten by doing a “crescent” lateral torsoplasty which is a “C” incision which connects the armpit with the inframammary fold to eliminate the saggy skin on this area to create a nice, smooth and tight lateral torso. Liposuction may be done at the same time

Abdominoplasty (Tummy Tuck) And Lower Body Lift

The main purpose is to eliminate excess length of saggy skin on the abdomen and is done through an incision right above the pubic area and may be short (ending on the hip bone) or extended (ending further back 3-4 inches beyond the hip bone) or circumferential which the majority of times will be more like a Lower Body Lift to combine with Buttocks Lift (wrinkly buttocks), Fleur de Lis to remove the excess width of saggy skin and can be used in combination with the regular, extended or circumferential tummy tuck or lower body lift.

Most male patients do not need muscle repair, however, if it is needed it will be done.

Pubic Lift And Reduction

A large percentage of obese male patients develop very large thighs and pubic area, creating a condition called "Buried Penis.” After weight loss, the area becomes saggy with a lot of volume. The treatment may be just a thigh lift or in combination with pubic reduction and will help greatly to recover the normal length and function of the penis. Normally this procedure is combined with abdominoplasty, tummy tuck or body lift.

Thigh Lift

Excess of thigh skin is always an excess of width and in very few patients the excess of length especially on those cases where the excess is only on the upper third of the inner thigh.

With an excess of width only, the procedure would be a Vertical Thigh lift, which includes a short groin incision and a vertical incision from groin to inner knee. Depending on the severity of flaccid skin will determine the length of incision: mid-thigh, knee level or beyond.

Every patient is different so each surgery will be designed for each patient's individual specific needs and desires. Surgical results will reflect a natural looking, more appealing, youthful and physically fit masculine body, boosting confidence and self-esteem.

ABOUT THE AUTHOR Dr. Carmina Cardenas is a Board Certified Aesthetic, Plastic and Reconstructive Surgeon. She completed her residency and graduated with honors from the Mexican Institute of Social Security, at the Hospital of Specialties in Plastic and Reconstructive Surgery. She is owner of Beauty Enhance Plastic Surgery. Read more articles from Dr. Cardenas!

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