Can a Crater Deformity Be Fixed After Gynecomastia?

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.

Doctor Answers (31)

Fixing a crater deformity

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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. 

Baltimore Plastic Surgeon
4.5 out of 5 stars 32 reviews

Fat grafting can fix the problem

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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 muscle needs to be released and you need to move a lot afterwards and massage the area in order to maintain the release.

If there is a divot there, then you will need fat grafting, where fat is taken from another part of your body in a process like liposuction and placed in tiny droplets in to the divoted area. This will separate the nipple for the muscle for you.

Both surgeries are relatively small.

Lisa B. Cassileth, MD
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 10 reviews

Fat transfer

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Fat transfer can help. This involves taking fat from one part of your body, like your stomach, and putting it into the area of concern.

Can a Crater Deformity Be Fixed After Gynecomastia?

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Fat grafting may be a good option to correct for your concern.  Photos may better aid in this evaluation.  Good luck and be safe.

John T. Nguyen, MD, FACS, FICS
Double Board Certified Plastic Surgeon

John Nguyen, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 25 reviews

Gynecomastia Complication: Crater depressed deformity

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An exam is essential but from your description it would appear that you have internal scar adhesions between your skin and underlying pectoralis muscle fascia. Typically the adhesions are divided and fat transfer, lipoinjection often corrects this problem. See a board certified plastic surgeon.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 59 reviews

Male breast reduction: how to fix crater deformity

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A crater deformity after excision of fat and breast tissue for male breasts or puffy nipples is probably more common than is reported.  The best treatment is fat grafting under the areola and nipple area to reestablish a smooth glide plane between the skin and the chest muscle.

Jeffrey Ditesheim, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 27 reviews

Fat grafts fix contour deformities

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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
Brandon Plastic Surgeon
4.0 out of 5 stars 23 reviews

Gynecomastia Divots

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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 nipple from the underlying pectoralis and help fill in the divot.

Depression after breast gland removal

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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
4.0 out of 5 stars 7 reviews

Fixing crater deformity after gynecomatia

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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
Scottsdale Plastic Surgeon
5.0 out of 5 stars 107 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.