Enhancing Masculine Features After Massive Weight Loss

Abstract

Background: Whereas body contouring surgery aftermassive weight loss in women emphasizes sculpturedadipose and broader lower torso, little attention has beendevoted to accentuating the male physique. Objective: To determine if boomerang excision patterncorrection of gynecomastia with J torsoplasty combinedwith an abdominoplasty with oblique excisions directlyover bulging flanks provide effective and safe optimizingof muscle visibility and upper torso dominance. Methods: A description of comprehensive body contouringthrough an abdominoplasty and a series of obliquelyoriented ellipses of the male torso is followed by review of19 consecutive patients. Results: Seventeen patients were performed in a singlestage. Nine of the last ten cases included J torsoplasty andoblique excision extensions over the flanks. Of the 17patients responding to a ten-question survey, 15 were satisfiedwith chest improvement. One of the first eightpatients with a transverse lower body lift was satisfied withthe flank bulges. All of the last eight cases with directoblique flank excisions were satisfied with their lowerbody. Five patients (26 %), having a total of 74 operativeprocedures, had significant complications of chest hematoma,persistent hip and buttock seromas, superior NACedge necrosis, and distal necrosis of the fleur de lisabdominoplasty. One boomerang correction underwentminor revisions. One transverse lower body lift underwentmajor revision. No complications occurred in the last tenpatients, having oblique flank excisions instead of transverselower body lifts. Conclusion: Comprehensive excisional body contouringsurgery of a central high tension abdominoplasty with aseries of obliquely oriented ellipses throughout the torsoappears to provide low risk improved body contour for themuscular male. Level of Evidence IV: This journal requires that authorsassign a level of evidence to each article. For a fulldescription of these Evidence-Based Medicine ratings,please refer to the Table of Contents or the onlineInstructions to Authors www.springer.com/00266.