Body Contouring in the Muscular Male:
Dennis J. Hurwitz, M.D..
University of Pittsburgh, Pittsburgh, PA, USA.
PURPOSE: After excess skin and fat is removed, a traditional body lift suture advances skin and suspends ptotic breasts, Mons Pubis and buttocks. For men there should be a deliberate effort to achieve sweeping tight skin closure that reveals superficial muscular bulk and selectively highlights adherences. For skin to be tightly bound to muscle, the excess needs to be removed both horizontally and vertically.
By office chart review, there were 23 patients with Boomerang pattern correction of gynecomastia and chest wall laxity with at least one-year follow up. Resembling the native Australian weapon, the Boomerang pattern is opposing obliquely oriented elliptical excisions joining over the nipple and initially extending transversely to complete the upper body lift. In the seven last cases, a J Torsoplasty extension replaced the transverse UBL (Figure ).Indirect undermining and the opposing force of a simultaneous abdominoplasty obliterate the inframammary fold. To complete the effacement of the entire torso in six of the seven patients, the abdominoplasty is extended by oblique excisions over bulging flanks. Five of these seven patients were single stage.
RESULTS: Satisfactory improvement was observed in all 23 Boomerang cases. One disgruntled patient was displeased with distorted nipples after revision surgery. Complications were limited to minor suture line dehiscence and edgewise skin necrosis. Secondary surgery consisted of two nipple revisions and one liposuction of the inferior breast. There were no deaths. One major complication was a right side hematoma requiring operating room drainage followed by two-unit transfusion. In the subset of seven with J Torsoplasty and oblique flank excisions, tight skin and muscular contours were evident with no revisions.
CONCLUSION: Male body contouring should consider the entire torso. Bodybuilding males have pride in the appearance of their muscular development. Optimal body contouring drapes tight skin over well-developed muscles through abdominoplasty and strategically placed multiple oblique ellipses.
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