How Do I Correct Indents After Bad Gynecomastia Surgery, AND a Bio-alcamid Inject?

This is complicated. 9yrs ago I had chest lipo with Dr. P. L. and he messed me up and scarred me badly. To cover the indents, I had some Bio-alcamid in 6.5 yrs ago, but I still need more filler of some sort put in around the area to even things out. I was thinking about more Bio-A, but have since heard it can migrate (what percentage does this happen in?)as well as get infected (if new BA was to go into the old BA pocket?& may look lumpy. Do I get the BA removed & go for fat transfer?

Doctor Answers 9

You may need a custom implant

.You should consult an experienced gynecomasia/plastic surgeon to see If a custom implant is adequate for you.Fat transfer will likely not be enough to correct this sever problem 

New York Plastic Surgeon
4.6 out of 5 stars 52 reviews

Healing Concern Years After Male Breast Reduction

The areas after Gynecomastia Surgery may feel “lumpy” or irregular, and should decreases with time. Often massaging these areas will help soften the scar tissue. Also, 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. It's possible that any indentations could be addressed with fat grafting or cosmetic filler(s) if eligible.

Typically, its best to wait at least one year following the initial surgery to consider a revision. It is imperative you select a plastic surgeon who is #board-certified and has a great deal of experience with male breast #reduction. Plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your procedure. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Please be advised that each patient is unique and previous results are not a guarantee for individual outcomes. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Gynecomastia Revision

Hi patientx1,

Thanks for the post and photo. You appear to have significant contour abnormalities. Revision for over-resection is much more challenging than for under-resection. The options are as follows:

1. Fat flaps: Moving fat in your chest from one area to another. Not the best option for you due to the degree of thinning and the likeliness of not having fat flaps to utilize.

2. Fat grafting: Using your own fat (from different parts of your body) to inject. This may need several attempts as there is always a chance that some of the fat resorbs.

3. Silicone implants: Custom implants may be an option but also have their own disadvantages (infection, firmer feel,etc).

Difficult case, but I would seek out a plastic surgeon experienced in revision gynecomastia surgery.


Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 39 reviews

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How Do I Correct Indents After Bad Gynecomastia Surgery, AND a Bio-alcamid Inject?

This is indeed a bad problem.  I do not recommend using a synthetic filler for this.  Perhaps fat grafting would be a better option.  See a board certified plastic surgeon to evaluate your options.

John T. Nguyen, MD, FACS, FICS
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Compliications from Gynecomastia (male breast reduction) and Bio-alcamid

Bio-Alkamid is not yet approved for injection but I have read about its use and history of complications even many years after injection. The removal depends on the technique used to place it. If it were injected using a depot technique, it may be more easily extracted that if placed with a linear threading method. Once removed, the use of fat grafting, possibly in multiple sessions could provide a better long term solution.

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Gynecomastia surgery problems

This is now complicated

1: The original dents, and cannula marks from bad liposuction technique

2: Bio alcamid injections, If these can be localized and are superficial they may be removed. Then a series of fat grafting to the chest to fill in the dents and canula marks. this is not as easy because of the scarrig that will interfer with the take of the fat graft.

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Correcting Post Gynecomastia Problems- Fat Transfer is Safest Option

I lecture frequently on filler complications.  I would be very concerned about using fillers to correct your problem.  It would be much safer to go with a fat transfer solution.  It will continue to improve for a very long time after your surgery.

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Difficult problem but there is hope

Overresection of tissue can lead to depression/contour deformities from gynecomastia correction as you are experiencing.  The best solution to consider is autologous fat grafting - carefully removing some fat from other areas of your body that can tolerate removal (of course without creating any contour issues there) and injecting the fat into the deficient areas of your chest to smooth out the overall contour. 

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Fat Grafting Probably Best Option for Contour Problems after Gynecomastectomy

I agree that your situation is somewhat complicated.  Your best option at this point probably is to have the irregularity improved with fat grafting.

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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.