Abstract
Background
Whereas body contouring surgery after massive weight loss in women emphasizes sculptured adipose and broader lower torso, little attention has been devoted to accentuating the male physique.
Objective
To determine if boomerang excision pattern correction of gynecomastia with J torsoplasty combined with an abdominoplasty with oblique excisions directly over bulging flanks provide effective and safe optimizing of muscle visibility and upper torso dominance.
Methods
A description of comprehensive body contouring through an abdominoplasty and a series of obliquely oriented ellipses of the male torso is followed by review of 19 consecutive patients.
Results
Seventeen patients were performed in a single stage. Nine of the last ten cases included J torsoplasty and oblique excision extensions over the flanks. Of the 17 patients responding to a ten-question survey, 15 were satisfied with chest improvement. One of the first eight patients with a transverse lower body lift was satisfied with the flank bulges. All of the last eight cases with direct oblique flank excisions were satisfied with their lower body. Five patients (26 %), having a total of 74 operative procedures, had significant complications of chest hematoma, persistent hip and buttock seromas, superior NAC edge necrosis, and distal necrosis of the fleur de lis abdominoplasty. One boomerang correction underwent minor revisions. One transverse lower body lift underwent major revision. No complications occurred in the last ten patients, having oblique flank excisions instead of transverse lower body lifts.
Conclusion
Comprehensive excisional body contouring surgery of a central high tension abdominoplasty with a series of obliquely oriented ellipses throughout the torso appears to provide low risk improved body contour for the muscular male.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Similar content being viewed by others
References
Chong, T., Coon, D., Toy, J., Purnell, C., Michaels, J., Rubin, J.P.: Body contouring in the male weight loss population: assessing gender as a factor in outcomes. Plast Reconstr Surg 130(2), 925e–930e (2012)
Ozel, B., Sezgin, B., Guney, K., Latigoglu, O., Celebi, C.: A social evaluation of perception on body contouring surgery by Turkish male aesthetic surgery patients. Aesthet Plast Surg 39(1), 124–128 (2015)
Hurwitz, D.J.: Single stage total body lift after massive weight loss. Ann Plast Surg 52(5), 435–441 (2004)
Hurwitz, D.J.: Abstract 8: body contouring in the muscular male. Plast Reconstr Surg 133(45), 977 (2014)
Hurwitz, D.J.: Aesthetic refinements in body contouring in the massive weight loss patient: trunk. Plast Reconstr Surg 134, 1185–1195 (2014)
Hurwitz, D.J.: Boomerang pattern correction of gynecomastia. Plast Reconstr Surg 135(2), 433–436 (2015)
Clavijo-Alvarez, J.A., Hurwitz, D.J.: J torsoplasty: a novel approach to avoid circumferential scars of the upper body Lift. Plast Reconstr Surg 130(2), 382e–383e (2012)
Hurwitz, D.J., Rubin, J.P., Risen, M., Sejjadian, A., Serieka, S.: Correcting the saddlebag deformity in the massive weight loss patient. Plas Reconstr Surg 114(5), 1313–1325 (2004)
Hurwitz, D.J., Reuben, B.: QuillTM barbed suture I n body contouring surgery: a six year comparison study with running absorbable braided sutures. Aesthet Surg J 33, 44S–56S (2013)
Hammond, D.C., Arnold, J.F., Simon, A.M., Carpraro, P.A.: Combined use of ultrasonic liposuction with the pull-through technique for the treatment of gynecomastia. Plast Reconstr Surg 112, 891–895 (2003)
Gusenoff, J.A., Coon, D., Rubin, J.P.: Pseudogynecomastia after massive weight loss: detectability of technique, patient satisfaction, and classification. Plast Reconstr Surg 122(5), 1301–1311 (2008)
Letterman, G., Shurter, M.: Surgical correction of massive gynecomastia. Plast Reconstr Surg 49(3), 259–262 (1972)
Lockwood, T.: Reply to letter on high lateral tension abdominoplasty. Plast Reconstr Surg 98(1), 184–185 (1996)
Mentz, H.A., Ruiz-Razura, A.: Pectoral etching: a method for augmentation, delineation and contouring the thoracic musculature in men. Plast Reconstr Surg 120(7), 2051–2055 (2007)
Hoyos A, Perez M (2012) Dynamic-definition male pectoral reshaping and enhancement in slim. Athletic, obese, and gynecomastic patients through selective fat removal and grafting. Aesthet Plast Surg 36(5):1066–1077
Monarca, C., Rizzo, M.I.: New body contouring technique in male: the muscular sculpture. Aesthet Plast Surg. 39(2), 199–202 (2015)
Mitchell, R.T.M., Rubin, J.P.: The fleur-de-lis abdominoplasty. Clin Plast Surg 41, 673–680 (2014)
Capella, J.: The vertical medial thigh Lift. Clin Plast Surg 41, 727–743 (2014)
Richter, D.F., Stoff, A.: Circumferential body contouring the lower body lift. Clin Plast Surg 41, 775–788 (2014)
Hurwitz, D.: Body contouring in the male, chapter 5 in comprehensive body contouring surgery: theory and practice. Springer, London (2016)
Acknowledgements
No outside funding was received.
Author information
Authors and Affiliations
Corresponding author
Additional information
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
This article is being reprinted for ISAPS 50th Anniversary Special Issue.
Presented in part at the 2014 meetings of the American Association of Plastic Surgeons in Miami, Florida; Northeastern Society of Plastic Surgeons in Providence, Rhode Island; and the Ohio Valley Society of Plastic Surgeons at the Greenbrier Resort, West Virginia
Rights and permissions
About this article
Cite this article
Hurwitz, D. Enhancing Masculine Features After Massive Weight Loss. Aesth Plast Surg 44, 1241–1251 (2020). https://doi.org/10.1007/s00266-020-01811-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-020-01811-1