Patient-Friendly Explanation

Some men lose fat from the chest but are left with a drooping or puffy chest because the skin has been stretched or because gland tissue does not shrink with dieting. Surgery removes the extra tissue and tightens the chest so it looks flatter. It is best done once weight has been stable for several months.

Clinical Definition

Post-weight-loss gynecomastia is most often pseudogynecomastia, consisting of redundant skin with residual fibroglandular tissue after substantial fat loss. Surgical options include liposuction alone, subcutaneous mastectomy with skin excision, and free nipple grafting in high-grade ptosis; true glandular gynecomastia requires excision of the gland. Preoperative endocrine review excludes drug-related, hypogonadal and thyroid causes before surgery is planned.

Why It Matters

A loose chest is a common source of distress and social avoidance in men after major weight loss, and many assume nothing can be done. Knowing that it is treatable, and that glandular tissue must be assessed rather than simply suctioned, leads to better surgical planning and outcomes.