Uneven Chest After Gynecomastia Surgery

                  Breast
asymmetry is not uncommon in men with gynecomastia. This may occur for a
variety of reasons including asymmetry of breast tissue and asymmetry of the
underlying chest wall.

                  When
surgery is performed to correct gynecomastia it’s not unusual to have mild
residual asymmetry. In most cases this results in an acceptable result. In some
cases the residual asymmetry may be significant and revisional surgery may be
necessary.

                  Although
it’s not clear what type of procedure you had performed, it’s apparent that you
have residual gynecomastia and asymmetry is present.

                  In
the immediate post-operative period swelling and scarring may contribute to
asymmetry. It takes about six to twelve months for these problems to resolve.
Once this occurs, a decision regarding revisional surgery can be made.

                  Based
on your photos it would appear that you would benefit from bilateral
subcutaneous mastectomies through peri areolar incisions.
At this point, it might be helpful to seek a second opinion from a board
certified plastic surgeon. 

Thank you for your question. Asymmetry during the healing process is not at all uncommon after any breast surgery. as you are still in the healing stage. Final results will show within 6-12 months. I would recommend that you keep all your scheduled follow ups with your surgeon.

Asymmetry during the healing process is not at all uncommon after any breast surgery. Also, your incisions will go through a maturation #process following #Gynecomastia #surgery. For the first few months they will be red and possibly raised and/or firm. As the scar matures, after 6-12 months, it becomes soft, pale, flat, and much less noticeable. You may experience numbness, tingling, burning, “crawling”, or other peculiar sensations around the surgical area. This is a result of the #healing of tiny fibers which are trapped in the incision site. These symptoms will disappear. Some people are prone to keloids, which is an abnormal scar that becomes prominent. If you or a blood relative has a tendency to keloid formation, please inform the doctor.Bruising and #swelling are normal and usually increase slightly after the removal of any tape or foam. The bruising will decrease over 3-4 weeks, but may last as long as 6 weeks. The majority of the swelling will be gone within the first 3-4 weeks. However, it may take 6-9 weeks to disappear completely. Also, as you heal, the area may feel “lumpy” and irregular. This, too, decreases with time, and massaging these areas will help soften the scar tissue. The #compression garment helps reduce the swelling, and the longer it is worn, the more quickly you will #heal. It can also assist in the retraction of the skin. If you have any concerns about #healing, its best to ask questions of your surgeon or their nursing staff.

There can be multiple reasons for your asymmetry.  Some asymmetry is common, and may be due to preexisting underlying chest wall asymmetry, differences in your pectorals size (are you right handed?), or differences in amount of tissue removed.  You did not mention what techniques were used in your operation.  Given your degree of gynecomastia, I doubt that liposuction alone would be adequate.  If you only had liposuction, I think you will need a glandular resection (surgical).  If the asymmetry is fatty and the gland was mostly resected surgically, then additional liposuction may be helpful.  

Gynecomastia reduction can sometimes take 6-8 months to reach its final result after the surgery.  If there is residual asymmetry after, additional liposuction can be performed to even out the chest.  Good luck and be safe.John T.
Nguyen, MD, FACS, FICSDouble Board
Certified Plastic Surgeon

Without seeing your pre-operative picture it is difficult to make a recommendation. Without trying to sound sarcastic, it is rare for a person to be even. In fact the vast majority of women have a larger left breast. Differences in the skin, nipple position, areolar size, fat content, glandular volume, muscle bulk, and skeletal consttruct make it unlikely that the right and left breasts are ever perfectly even. Having said that, if you are dissatisfied with the results, seek a second opinion to review your condition and options for management.   

Hi Aa3125,Thanks for the post and the photo. I always tell my patients, your breasts are brothers not twins. It is improtant to not only discuss any asymmetry that may be corrected in the operating room but also the asymmetries that can't be corrected, such as musculoskeletal differences between the sides. It is difficult to advise you on whether you need further surgery based on a single photo. You would need to be examined in person to evaluate whether the asymmetry is due to excess breast tissue, fatty tissue,scar, or all of the above. At 6 months, I would not anticipate that there will be too much more improvement.Sincerely,Dr. Dadvand

It would not be uncommon for the sides of the chest to be slightly asymmetrical. After resection of the gynecomastia, the distinction between the two sides may have become more apparent to you. You haven't described the surgical method used. It you had liposuction alone, this would not have been enough and resection of additional glandular tissue would be warranted. If you had resection of breast tissue, it would appear that you could benefit from further resection.

No surgeon can ever guarantee perfection or exact symmetry between the two sides (most patients start off with differences between the two sides) but that being said, it looks like you may be able to remove more tissue from both sides.  I would recommend you get a second option if you are not happy with your results and see what your options are.

Slight asymmetry is acceptable ,but when excessive an attempt should be made to correct it by liposuction and/or excision of the gland. Correction means similar breast size but not exact size and/or shape.In this particular patient another attempt can be done if patient is not happy.But of course the patient has to be realistic. Before photos are important and I wonder how large were the breasts prior to the surgery? and if after surgery there was a significant change in size?