get rid

How To Get Rid Of Chest Fat - Before and After Gynecomastia Removal Surgery with Explanation

it's a benign condition yet look what

the consequences can be the whole person

I just got a room and I interviewed this

patient and we walk in a video he didn't

know anything about a video did he know

so I had no idea and we sort of

spontaneously get on this whole video

bandwagon cuz I look for cool cases

obviously we do a lot of it we try to

look for cases that are kind of cool

anyway he got me pumped up gonna be

world famous when I grow up I want to

look like him I do okay so the first

things first things you know we've

already talked to we're ready madam in

everything so these these people as cool

as the day is long but notices shoulder

position so Jordan come over here and

just check this out so you got this big

C shaped thing this C shaped thing means

you're flexing here in the mid upper

thorax and then the shoulders come

forward so part of the recovery from

this procedure is that has to be

reversed so straighten up all the way oh

my god oh my god look up tall he is now

he was 511 now he's 6 4 and so look at

his shoulders it's down and back and I

tell you that what we're trying to do in

his particular case is connect his chest

with his head and we're going to break

this connection then we have to freeze

his head up it starts most visibly with

the body habitus because that we can see

here it's sort of invisible stuff we can

talk about and all this kind of stuff

but his body habitus said it's basically

we have to free him up and posture is a

number one when I told his amazing

girlfriend that she has to make sure

that she sort of keeps an eye on him and

make sure he does what he has to do so

first thing I told him when he popped

out for sure it originally was he's

getting too much Sun so stay out of the

Sun we don't want his skin cancer and

he's in great shape you know he's got no

body fat here again when I come back I

want to have a body like him but what

you can clearly see is just big big

gorillas okay and he's got this stuff

for sure okay

and it's real and this puffy gorilla

here is not cool

and it changes him and it holds him back

from what he should be doing in life and

that's why we're treating this because

it's gynecomastia is not harmful in and

of itself it just gets into our head and

we have to basically break this whole

connection here so as I told him we're

gonna free him up by taking care of this

tiny incision here a tiny incision here

we may pull out something cool here you

know for the audience because they like

you guys like when I pull out something

cool I think we're going to find

something cool which will be nice and

then we may use the internal flap

technique to kind of reconstitute stuff

so that he doesn't have a depression

because we're removing all of it so

we're not gonna leave stuff so he

doesn't have a depression we're gonna

from the top down remove it and then if

I have to build a new internal under

blah blah I'm gonna show you how we do

that in the video and that's what I'm

working on my paper by the way as well

the next paper is gonna be adjunctive

techniques used in gynecomastia in other

words techniques that look at the hands

thank you it's like whoo personally I'm

just really happy for both of you and as

I say go Tex Arkana actually doctor I do

have a question Shogun might be valuable

so of course we see the puffy areolas

now how does that go back to its normal

shape that's the biggest thing

well Italy for me tonight well this is

the deal it's like a balloon and it's

inflated right now gotcha

but your skin cuz you're young your skin

still has elasticity mm-hmm take out the

air your balloon goes back and that's

the beauty of it so the key for a lot of

guys is that you got to make sure that

you don't need to necessarily incision

around the areola to make this smaller

it'll be smaller just on its own now if

you have terrible skin and you lost a

thousand pounds that's another story but

the fact is that you'll see this on the

table actually I'll just go and what's

cool too is that you see the color that

he has now it's gonna get dark because

think of it as like a I got a I'm in

Texas so we got to think of like a

retention pond that it's got the full of

water and is the retention pond like in

the in the summer evaporates it starts

to get darker and darker because all the

sediment in the water starts to

concentrate and so all the pigment cells

that he has around this whole area will

an area that's a lot smaller so

therefore it gets a darker if you look

at it I'll go back to my videos or even

look online you'll see yeah it's a lot

darker because it yeah and it shrinks

off same thing you know it'll it'll

shrink up nicely and this will be like

literally on the table so what we'll

show is hopefully his sample going in

and out and how it's like inflated

deflated and all that kind of stuff good

question though yeah can we talk about

that why whenever I take a cold shower

there's little myofiber or blasts what

just little motors in there little

muscle let's and they contract up so

they get stimulated so either you live

in Minnesota or year-round or you don't

I mean basically and if you stimulate

them Sophie that's why a lot of guys

will say they rob them and all that kind

of stuff before special occasion or

whatever because that stimulation fires

off these little muscles and it just

kind of squinches down but the fact that

the matter is we won't need that we you

know because once we take the air out of

those balloons just goes right back so

good question let's get this party going

all right so the thing about him he's

owned one up front obviously he's got

significant puffy nipples and when I

felt them I could definitely tell he's

got gland

not everyone has gland you can have

puffy nipples from just fat and fiber

fatty and all that kind of stuff but

it's all gynecomastia tissue

gynecomastia tissue is unique to this

area right here zone one always this

other stuff that I do around these other

zones it's just generally fat you can

see how it's stuck it all starts at the

nipple and it goes back okay so when I

say treatment is top-down it basically

means the mountain is here and then

everything below it is the base right

and that's this face here

I want to preserve as much normal tissue

as possible because he doesn't have a

lot of fat so I don't have a lot to work

with so therefore I want to preserve

everything that's good now I cut through

the skin here a tiny incision no big

deal so that shows me my mass which is

right here

you can see the white and then I'm gonna

get in here and just spread the tissue

and again you can see the white so I

mean

and you can see the normal fat those

flat globules are just fat and now what

I'm doing is getting around the mass

preserving the fat if you will because I

may need that for my internal flap which

is my way of giving me an out in order

to get the entire specimen removed I am

NOT going to leave specimen in here so

he doesn't have a depression we're gonna

have our cake and eat it too so I can

feel it releasing from the backside okay

and then I'll usually get in here and

just crank on this a little bit and

wallah you'll see this pop out again all

this fat is good stuff and then we'll

see whether or not we need to use the

internal flap all right so I release

this it's all freed up remember it all

starts at the the nipple so the idea of

a top down means that I remove

everything under the nipple here you can

see how the nipple see that and then

watch when I pull on this and it's

attached to the nipple I am not leaving

anything boom that's all gone so this is

the mass that he had it's shrunk down a

bit obviously because I did some Vaser

but you can see immediately he's got

some nice skin retraction look how small

as a reelin is now and this is what we

talked about immediate retraction so

this is normal tissue there's no there's

no die no left this is just normal stuff

this is some extra fat here which I

actually I'm going to trim a little bit

and I'm gonna leave some of it because I

don't want to depression but I want to

get what I want to get and I want to

leave what I want to leave so what I'm

going to show you here is the origin of

the puffiness right so see here this is

flat and it's already shrunk down

tremendously because this was removed

this is the gland all the glands starts

immediately under here so you can

imagine this was the cause so it was

puffiness

see that that's the puffy

that's the puff Diddy all right it's

this mask this was that I called the air

in the balloon and then once I removed

the air of the balloon

boom look at that it just shrinks down

and which will also notice that as it

shrinks down here it actually gets

darker because it's more concentrated

now flaps let me think

I'm looking around and I could see his

muscle right here okay that red stuff

but I have this layer of fat it's

actually a little bit bigger than I

needed to be so I don't need all of this

I don't need to save it so now I'm just

expertly sort of contouring this so that

it's perfect and if I need to put a

stitch in I will but I'm trying to get

that nice and flat which it is and then

we're gonna do it a piecemeal reduction

of some of this extra tissue if you will

I might actually use a tissue

that means the stitch here because see

now that I'm done here I could feel

there's this ledge of tissue up over

here alright and then there's a little

void where I took the mass see that's

right here that's the that's the muscle

down here and there's a ledge of tissue

over here and then I'm going to put a

single stitch in so I'm gonna get in

here with a stitch this is called my

quilting suture and basically I'm

grabbing some of this lower flap all

right there's the intervening muscle

right here I'm grabbing some of this

superior flap and this is normal tissue

this is not gynecomastia tissue and I'm

gonna put a suture

and by doing this I've essentially

reconstituted the layer of fat that we

want to support this nipple areolar

complex so he doesn't have a conditioned

cavity or depression so the idea of

leaving tissue so you don't have a

depression is just not the way to go

okay there's no depression here and we

did remove all the tissue and he still

has a nice contour notice this is a

small area notice this is a bigger real

and now I'm gonna come over here and do

the same thing on this side we're gonna

leave that up there so you can all stare

at that for comparison little

periareolar incision the incision is

just at the border of the the beach and

the sand so to speak and I've already

heard that some people are stealing my

beach and sand analogy is that true mark

yeah boy oh boy

idea so I'm at that beach sand interface

here remember that the Vaser really made

this possible without an electrosurgery

device because the the laser does take

care of the vessels that are feeding

this tissue doesn't just exist it has to

have blood supply and so this is the

tissue yeah and again I take it from the

top down approach gotta get it all we're

not gonna leave anything so that there's

no depression or anything we're gonna

remove it all you can see the size of

this mess here and get my favorite look

at my nurseries trying to do this

surgery you could see when she pulls on

that okay look at that that white stuff

now look at this white stuff yeah this

is real gland you don't have to have

this gland half guy no comes in various

forms but look at that so this is normal

all right this is normal fat that's the

gland so again I'm not leaving any of it

look at that I'm right underneath the

areola because I don't want to leave any

I don't want this to recur and I don't

want him have puffy nipples that's why

he's not happy all right and then you

can see the upper limit is this

normal stuff I'm going to leave some of

it boom there you go look how this is

already contracted down and notice too

that there's a little depression right

look right see there is a depression

because I just removed the mast you

remove a mast you get a depression right

that's just the way it is so I'm gonna

look back in here and I'm gonna go okay

so this is some normal tissue here and

it's got a lot of the good stuff up here

I want to keep the the the man the man

sort of coolness here I don't want them

to be too skinny and this is normal so

I'm gonna thin this just a little bit so

it doesn't have like a step off alright

just thinning this up a little bit like

that alright and then I'm gonna stick a

stitch in here my internal stitch grab

some of this I'm above grab some of this

from below alright and what that's gonna

do is cover his muscle so he doesn't

have depression

so he doesn't have any adherence which I

think I'd pull that out maybe maybe not

well put a few stitches in here so this

is a Vicryl stitch this is absorbable

this is gonna go away let's take another

stitch in there it's more secure than

this one some of this good tissue here

and suture it to this good tissue here

and again what I call this is I'm

reconstituting the floor I'm in other

words this is the foundation that's

going to support the nipple areolar

complex in other words give him a normal

layer of normal fatty tissue and remove

the mass okay so there you go just those

two simple stitches there's no tension

this was a relatively easy one and you

can see how that got darker and it

already contracted down and this Cyrilla

is a lot smaller than his previous

areolar so and he has a nice layer of

tissue here to support this tiny little

incision that heals beautifully when we

close it and this is it so this is a

homerun as I call it this is the edge of

his PEC muscle this is nice and flat

it's already

this is a simple case in a lot of ways

but on the other hand it'll astray

--tz-- this technique of an internal

flap which really is something I'm

working on hopefully I'll be publishing

that soon enough because it's proven to

be pretty critical in achieving the end

result which is basically you guys

having your cake and eat it too we get

rid of all the gynecomastia and there's

no depression so there you go hope you

enjoyed it yeah oh it's a great another

really good oh that's right you haven't

seen it no oh hell-oh okay so this is

all about

wow I get a kit like that the whole idea

was you I had to make sure that he

didn't look did you look No are you sure

I thought she she changed these top pads

and she's like are you sure no no no

cheating no cheating yeah no cheating I

so so this is the unveiling feels like

Christmas time alright you know whatever

okay lay back relax yeah and you know

and it's like obviously he sees in good

shape to begin with there's no question

about that the issue were that we always

had with him was this the unusual nature

of it you know like how odd he's got

this great figure and yet he had these

word hid this word chest all right so a

little look at you come with various

presents and wow look at that

yeah good thing this isn't pg-rated

because I agree with you holy holy crap

ollie

alright so yeah now remember this is

early yeah so you got time to shrink the

realism gonna get smaller you could see

his pack he doesn't have that fullness

on the end there but really it's what's

going in those pretty eyes of his that's

making the difference in what he's

seeing

and what I always try to tell people is

that this is also to some degree

instantaneous is really not a lot

if your surgeon says you gotta wait a

long time to have the swelling go away

it's probably didn't remove as much

tissue as you had and he also remember

too that oh yeah I remember this is

yesterday's case and he pulled out those

Nuggets right you had those he had the

Nuggets and so you know you could see

his his nipples are no longer puffy and

they'll never get puffy anymore he does

have some internal stitches in there

which is pretty cool but the fact is

surgically I got this under control and

he is he's done really so now the

connection between here and here is

what's working and so what I try to tell

people is that you know what is it that

you see and if you could look in the

mirror and feel good that's a good thing

right yeah I mean just think about it

it's just that whole body image is

important for us we don't have to be

perfect but we still have to sort of

feel good and the reason why I encourage

people to get this fixed is that you

know don't live with another day flex

your muscle a little bit yeah yeah okay

relax hey take it easy there big boy

don't bust he don't bust my stitches he

does have some sutures in there again to

get complete removal of the tissue

sometimes I have to do these internal

flaps so the idea of leaving tissue so

that you don't have a depression right

is is a myth how about that all right

we'll take that as a myth so know if you

leave it's crazy I've never seen that

before yeah that nice little yeah so the

lateral border of the pectoralis major

member the muscle here inserts into your

humerus and so this is the lateral

border and so ideally we have this sort

of boomerang if you think of a boomerang

it's this flatter area through here and

that travels up to the lateral muscle to

your crease here the axillary crease and

so this view here is just the view and

then what happens is you get fullness up

here in zone 0 and zone 1 and that's

sort of obscure as this whole area you

don't see any hockey stick you actually

see a little bit of a breast which is

not that cool for guys anyway and so you

know he's just gonna go into the routine

post-op stuff he's pretty swollen here

so he's actually gonna get more

definition and and the areal will the

areolar will shrink down I mean it's

probably down 40% now

another and it's gotten darker didn't

get dark yeah yeah so like I said it

gets darker because I made the retention

pond analogy where you know as the water

evaporates so to speak you have more

sediment to water ratio it's more

concentrated now so there's more

concentrated pigment cells so yeah this

was cool the the great unveiling so how

do you think you're gonna do

psychologically now dude like like I

said I'm ready to walk out of here with

my shirt off like I think the main thing

is gonna be you know being aware of my

posture and changing that whole dynamic

and when that happens just undoing the

years of the forward lean the forward

head the rounded shoulders once that's

fixed to this game over yeah game over

right and so you're so you're and we're

getting this again we're getting this

film like someone's filming us filming

him which is cute but I think she's

gonna lend us that so so we can get the

whole thing what what I like about that

is it's a family affair too you know and

your girlfriend came here to work with

you there's a gentleman now I just

talked to from California and his mom is

here which is I love everyone else I

love moms but I love people I love

making this as a family affair in the

sense that people who care right because

it's a sensitive subject right guys

don't want to talk about it and then

sometimes it's like I can't even tell

somebody 100 percent man I can't tell

someone sort of come with me I'm like

come on man I mean you really have to

tell someone find your mother your

girlfriend your wife or you know

somebody but share it share it so you

know it's funny everyone can have cake I

know it's not limited to a particular

group of people right it can if it

affects everybody so good-looking

overweight underweight short tall

everything every color every permutation

there's it does not discriminate which

is a good thing but it does afflict

everybody and we all suffer the same way

so and so now it's all about sharing the

love which basically means the the

Brotherhood which means that

gynecomastia is bigger than he it's

bigger than me and we have to share I

hate he does videos and we appreciate

that it's like the guy that we're going

to

into and fix right now and at first I

said to him and he has a really advanced

case real sweet man and I said you know

we're gonna do a video and he's like mmm

and then he thought about it for about

20 seconds and then he was like yeah Bob

yeah I'm gonna do a video in other words

he just had his come-to-jesus moment

where it's like no it's bigger than him

and I want to help and so I saw that

transformation I wish we go to kind of

caught that on video because you could

see his wheels returning and then he

said no I want to do a video and that's

really what I want to hear it's not like

and I'm worried about my tattoos and I'm

worried about what people think

amen you're gonna potentially help 30 40

million men so it's bigger than all of

us so that's just a cool thing so anyway

here's our unveiling and then we're

gonna catch some post ups with him and

he's gonna post some stuff online maybe

and educate and help out as well and

just another wonderful day at the AGC

and as a reminder appreciate him coming

to us from elsewhere and I appreciate ya

know it means a lot man right it means a

lot

it's it's a mutual sort of love fest

here because we're all on the boat

together and we're all rolling in the

same direction so it's all cool stand-up

Ashley in a pg-rated he's using them

French words now look at that and you're

swollen yeah you know and so it's only

gonna get better which is just amazing I

love this you know seen what you seen

yeah ya know it's just like the first

look it's like the great unveiling you

know and I'm glad yet you held them off

from looking no cheating

yeah and this is a good way for us to

capture that whole experience everyone

has a little bit

different reaction it's just your it's

just yeah your your just your whole now

which is really interesting and you know

the funny thing is it's like it's a

benign condition yet look what the

consequences can be to hold the person

back it's just enormous it's like having

an anchor and your anchors been removed

yes

now he's going to get into the whole

modeling to the nth degree yeah yeah

yeah he's gonna be the one no you got to

put a shirt on sir and it's like if you

knew what I knew you'd be happy to sure

it is all yeah put a shirt on

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