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Can a Crater Deformity Be Fixed After Gynecomastia?

asked 3 years ago by weagle in Alabama
Latest answer by Raj S. Ambay, MD
Question viewed 6,929 times
Tags: craters, revision

Is there anyway to fix a crater deformity from a bad gynecomastia surgery? My nipple and area around it sinks in when I raise or flex my arm. I do not have anymore fat on my chest that can be removed to lessen the contour difference. Any advice or guidance would be extremely appreciated. Thanks in advance.

27 answers to Can a Crater Deformity Be Fixed After Gynecomastia?

+1

Raising Your Arms Is Not The Real Test

When the arms are raised the entire chest structures change.  You must decide on the outcome of your gynecomastia with your hands by your side looking into a mirror. You also have scar tissue which alters how things appear.  If the crater appears with your arms down this is a issues and fat grafting or a fat fap can correct. see video
Miguel Delgado, Jr., MD

San Francisco Plastic Surgeon

www.dr-delgado.com

+2

Fat grafting can fix the problem

Your problem sounds a little tough, because the nipple seems stuck to the underlying pectoralis muscle, which means it gets worse when you stretch that muscle, like lifting your arm. What needs to be done depends on whether you had too much tissue removed or not. If there no contour deformity (divot) when you are lying on your back, then the problem not overresection - the problem is that the areola stuck to the underlying pectoralis fascia. In this case, the scar between the areola and the... more
Lisa B. Cassileth, MD

Beverly Hills Plastic Surgeon
+1

Fat grafts fix contour deformities

While this is a difficult situation, fat grafts may be your answer. The fat can be taken from anywhere (commonly your abdomen) and transplanted under the "crater" deformity.
Raj S. Ambay, MD

Tampa Plastic Surgeon
+1

Gynecomastia Divots

Gynecomastia surgery can be complicated by divots under the nipples. The two main causes are 1. an under resection of the surrounding gland/tissue or 2. over resection of behind the nipple. Either one causes divots in almost any position. Divots that become apparent in certain positions is likely due to adherence of the of the nipple to the under lying pecoralis fascia. Fat grafting is the solution to the divot in this scenario as it will free the... more
Chad K. Wheeler, MD

Spokane Plastic Surgeon
+1

Fixing a crater deformity

You will need a combination of fat grafting and possible some additional liposuction in order to help improve the crater. Make sure you see someone with some experience. Good luck.
Ronald Schuster, MD

Baltimore Plastic Surgeon
+1

Depression after breast gland removal

I think the best option is a series of fat injections into the area, being done about 6 months apart to fill in the space between the skin and your pectoralis. Not all of the fat survives the first time, usually due to the scar tissue and that is why it usually needs to be repeated, but you will already look better after the first one heals.
Julio Garcia, MD

Las Vegas Plastic Surgeon
+1

Fixing crater deformity after gynecomatia

Hello, This can be caused by too much tissue being removed from under the areola or not enough from the periphery of the chest or both. If there has been too much tissue removed, fat grafting is the solution. All the best, Dr Repta
Remus Repta, MD

Phoenix Plastic Surgeon
+1

Gynecomastia

A fat transfer to athe area should work. Consulta with your surgeon to determine the number of injections you will need to fill the void.  Best wishes!
Christine Sullivan, MD

Columbus Plastic Surgeon
+1

Crater Deformities Can be Improved

A "Crater Deformity" after gynecomastia surgery can usually be improved, although not always eliminated. It's caused by a lack of adequate tissue beneath the nipple-areola. Fat injection to the crater done in one to three treatment sessions will usually work well.
George Sanders, MD

Los Angeles Plastic Surgeon
+1

How to treat a contour deformity after male breast reduction

A depression around the nipple/areola region can occur during a male breast reduction (gynecomastia) if too much fat or breast tissue was removed during your procedure.  I would recommend a fat transfer from another area (ex. abdomen) to fill in this defect.  This can be done under local anesthesia with relatively minimal pain and downtime.  You may need more than one session as some of the transferred fat may atrophy (shrink) and require further filling in the future... more
William Bruno, MD

Beverly Hills Plastic Surgeon
+1

Gynecomastia complication

Sorry that your outcome did not meet your expectations.  Thankfully, many complications that arise in plastic surgery can be improved or alleviated.  The most likely fix for this problem is fat transfer from another region.  This may take several treatments to achieve an optimal result.  Good luck!
Jason R. Hess, MD

San Diego Plastic Surgeon
+1

Indented areola after the correction of gynecomastia can be corrected

If your areola is indented, it means that you have less tissue behind your areola than you do behind the rest of your skin.  First, you must wait for a few months after your surgery to make sure you are fully healed and are seeing the real result and not being fooled by swelling.  After 6 months, if you still have the indent after your gynecomastia procedure, you will either need more liposuction to reduce the fat under the skin surrounding the nipple or you will need something... more
Parham Ganchi, MD

Wayne Plastic Surgeon

www.ganchi.com

+1

Fixing a sunken nipple after gynecomastia surgery

It's important to leave a little nub of breast gland under  the nipple so the nipple does not sink in or get scarred down to the pectoralis muscle.  It sounds like your gland tissue was over-resected. I would consider fat transfer to this area to plump it up and also provide some padding between the muscle and the nipple.  Most men have some extra flank fat (love handles) that could serve as a donor site.  It may take more than one session of fat transfer but... more
Lisa L. Sowder, MD

Seattle Plastic Surgeon
+1

Crater deformity

First correction of a crater deformity requires a crater from your description it is not clear that that is what you have. Second the correction depends on the severity of the problem and the underlying anatomy of the specific individual.  Third to assume you will look perfect in every possible position with or without muscle contraction is frankly  not realistic after surgery. Fourth after surgery there is typically scar contraction that occurs and is maximal at 4 weeks on... more
Jay M. Pensler, MD

Chicago Plastic Surgeon

www.plasticsurg.org

+1

Correction or touch-up can be done safely with grafts

In a crater deformity, it can most often be corrected with a touch-up procedure where the surrounding excess fat is planed down to the crater level and/or some fat is grafted into that area to build it back up.  It is not unusual to need a touch-up in about 10-15% of cases.  It is usually an outpatient and minimal down-time procedure.
Navin K. Singh, MD

Washington DC Plastic Surgeon
+1

Crater surface depression after gynecomastia resection

Aggressive removal of gland and fat tissues with gynecomastia resections can leave a depressed contour irregularity.  Severe crater deformities can be improved with fat grafting, biological matrix implantation, and volume enhancement injections.  Subcision may be required for dense scar that tethers the nipple to the underlying muscle fascia.
Randy Wong, MD

Honolulu Plastic Surgeon
+1

Contour problems after gynecomastia surgery can usually be fixed.

Over resection of the glandular tissue behind the areola and inadequate feathering of the fat peripheral to this can leave a thumb print of the areola.  Treatment is to make the distribution of the tissue on the chest wall uniform.  Suction alone might work but direct excision might be necessary.
Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon
+1

Crater deformity after liposuction can be fixed

  After liposuction for the correction of gynecomastia, it is possible to have a depression or a crater deformity. This may be due to excessive liposuction in one area. In our practice, we have seen many patients who have had this deformity after having received liposuction at another facility. We have helped these patients by doing a revision surgery that consists of ultrasound liposuction as well as regular liposuction and then fat grafting these deformities. For your case is very... more
B. Pat Pazmino, MD

Miami Plastic Surgeon
+1

Crater deformity of chest

A crater deformity after gynecomastia surgery is very difficult to correct. Sometimes this can be corrected by autologous fat injections and may even be corrected wtih alloderm.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Fat injections will help deformity after gynecomastia surgery.

Hi. 1)  We have seen this problem in New York City.  I know exactly what you mean by a crater. 2)  This depression in your chest can usually be improved a lot with fat injections.
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Contour deformity after gynecomastia

What it sounds like you are describing is a contour deformity after gynecomastia. If your surgery was recently performed I would wait up to six months to allow all of the swelling to resolve and then reevaluate the area. If this deformity still exists then fat graft would be a good treatment to improve the contour of the area. This may take several treatments. It is best to revisit with your surgeon so that he/she can monitor your progress and determine if this matter requires any... more
Earl Stephenson Jr., MD, DDS

Atlanta Plastic Surgeon
+1

Saucer deformity (dimpling and inversion) of nipple following gynecomastia repair.

SEE VIDEO BELOW It is normal to have mild dimpling and inversion of the nipple following gynecomastia surgery or even in normal unoperated males. In rare circumstances, I have treated this problem with fat injections. It typically takes 2 or 3 sessions and can be performed under local anesthesia if desire. On one other occasion I treated this with a dermal fat graft but this requires more invasive surgery with a donor site; it was "so successful" the patient requested removal. more
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Crater deformity after gynecomastia is hard to fix

The infamous "crater" or "saucer" deformity after Gynecomastia surgery due to over resection of fat is hard to fix. But I am not so sure that that is exactly what you have. Classically, such deforming indentation is usually present at rest - yet you state "My nipple and area around it sinks in when I raise or flex my arm". That leads me to believe that your deformity, or at least a large part of it, is due to adherence of your "nipple and area around... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Repairing a dent after gynecomastia surgery

If too much tissue is removed or if scar tissue develops between the pec muscle and the nipple, you will have contour irregularities. These are tough to fix but fat grafting to the indentation after releasing its tethering can help. This may need to be repeated and may not totally correct the problem.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Structural fat grafting would improve the saucer deformity

Structural fat grafting using fat from another area would be your best bet.  This may also require release of the tethering scar tissue at the same time which could be done using your original scar.
York Jay Yates, MD

Salt Lake City Plastic Surgeon
+1

Contour irregularity with gynecomastia surgery

Contour irregularities can be improved after aggressive gynecomastia surgery, but preventing these contour irregularities is the mainstay of therapy.  Fat grafting and breast prostheses that are customized are long term solutions.
Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon
+1

Gynecomastia and Scarring

Gynecomastia requires removing the entire male breast gland. Some gentle liposuction at the edge of the removed gland will decrease the chance of cratering. In the recovery period, there is always stiffness and scarring underneath the skin and especially around the nipple area. It does require several months for the firmness and scarring to soften up. The most important thing to do during your recovery is to massage the area, and the more aggressive the better. Most of the time the... more
T.Y. Steven Ip, MD

Orange County Plastic Surgeon

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