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Skin Excess Overview

  • Skin Excess is the most accurate way of determining gynecomastia type and optimal treatment. It is used primarily by Doctor’s
  • Chest Fold angle is the easiest way for patients to determine gynecomastia type.
  • Gynecomastia Type 1 and 2 are “True Gynecomastia” as there is minimal skin excess
  • Gynecomastia Type 3 has a significant amount of excess skin but is still can be managed with minimal incisions. Secondary skin tightening may be necessary for optimal results.
  • Gynecomastia Types 4, 5 and 6 have so much excess skin that it can no longer be managed using only an incision around the areola.
  • Dr. Cruise has crafted multiple ways to keep the incision as short as possible.
  • However, treating a Type 4 patient using a Type 3 incision will almost certainly result in a “Deflated Look” and a result worse than if patient never had the surgery at all.
Gyne. type Pinch Test Skin Quality Good – subt 1 cm BT size Chest fold angle Chest fold sag Typical appearance
Type 1
< 2 cm
< 45
0 cm
Puffy nipple Horizontal chest fold
Type 2
2-3 cm
< 60
1+ cm
Rounded chest fold Tight skin - Negative “bounce test”
Type 3 early
3-4 cm
Loose skin – Positive “bounce test”
4 cm
4-5 cm
Type 4
5+ cm
> 90
Chest sag – creates chest roll
  • Chest fold angle is the single best determining factor of gynecomastia type.
  • Chest fold sag determines how much weakening has occurred within the chest support. As it sags it rounds out creating a more feminine / loose appearing chest.
  • Nipple sag – determines if the skin has stretched enough that the nipple has fallen off the Pec. Muscle and into the chest fold resulting in “cratering”.
  • Knowing the gynecomastia type you have prior to consultation makes helps greatly with research and expectations.
  • It is essentail to distinguish between types 2, 3 and 4 as the treatments are dramatically different.
  • Determining chest fold angle is the single best gynecomastia type predictor for patient’s. See Below
  • Determining exact amount of excess skin via “Pinch Test” is most accurate and is done by Dr. Cruise.
  • If your chest bounces when running then excess skin is likely.