After excess skin and fat are removed, a body-lift suture advances skin and suspends ptotic breasts, the mons pubis, and buttocks. For women, the lift includes sculpturing adiposity. While some excess fat may need removal, muscular men should receive a deliberate effort to achieve generalized tight skin closure to reveal superficial muscular bulk. For skin to be tightly bound to muscle, the excess needs to be removed both horizontally and vertically. To aesthetically accomplish that goal, a series of oblique elliptical excisions have been designed.
Twenty-four consecutive patients received boomerang pattern correction of gynecomastia. In the last 12 patients, a J torsoplasty extension replaced the transverse upper body lift. Indirect undermining and the opposing force of a simultaneous abdominoplasty obliterate the inframammary fold. To complete effacement of the entire torso in 11 patients, an abdominoplasty was extended by oblique excisions over bulging flanks.
Satisfactory improvement was observed in all 24 boomerang cases. A disgruntled patient was displeased with distorted nipples after revision surgery. Scar maturation in the chest is lengthy, with scars taking years to flatten and fade. Complications were limited and no major revisions were needed.
In selected patients, comprehensive body contouring surgery consists of a boomerang correction of gynecomastia. J torsoplasty with an abdominoplasty and oblique excisions of the flanks has proven to be a practical means to achieve aesthetic goals. Gender-specific body lift surgery that goes far beyond the treatment of gynecomastia best serves the muscular male patient after massive weight loss.
From the Hurwitz Center for Plastic Surgery, University of Pittsburgh Medical Center.
Received for publication July 7, 2014; accepted August 13, 2014.
Disclosure: The author has no financial interest to declare in relation to the content of this article.
Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s Web site (www.PRSJournal.com).
A "Hot Topic Video" by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to PRSJournal.com and click on "Plastic Surgery Hot Topics" in the "Videos" tab to watch.
Dennis J. Hurwitz, M.D., Hurwitz Center for Plastic Surgery, University of Pittsburgh Medical Center, 3109 Forbes Avenue, Pittsburgh, Pa. 15213