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 33

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. 

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 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 13 reviews

Crater Deformity After Gynecomastia Surgery

Hi weagle,

Thank you for the post. Based on reading your post my conclusions are:

1. If you have a crater deformity when your arms are down or you are laying down then too much tissue was removed. The treatment for this is to add tissue, typically by harvesting fat from one area of your body and carefully injecting it into the deformity.

2. If you only have a crater deformity when raising your arms but not any other times, then you likely have scar tethering. This means that your areola is sticking down to your muscle via a scar. If massage does not help, then you would need surgery to release the scar.

Regardless of the reason, I would wait at least 6 months before doing any further surgery.

Sincerely,
Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 16 reviews

Fixing craters

Fat grafting (transfer) or dermal fat grafting can fill in any divots under the areola.  One should wait minimum of 3 months before this touch-up.

Tim Neavin, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

Fat transfer

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?

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
4.5 out of 5 stars 31 reviews

Gynecomastia Complication: Crater depressed deformity

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 63 reviews

Male breast reduction: how to fix crater deformity

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 33 reviews

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.

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

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.