Areola Revision / Reduction Post-Gynecomastia Surgery

The areola will not shrink anymore.  The size wil need to be reduced.  This is a simple procedure and you should get a good result.

When post-op deformities exist after body contouring surgery occur, you don't have to live it.  In fact, revisions are the norm.  An online question isn't the same as an in-person consultation but in these pictures, there is room for improvement.  Scar excision, spot-Vaser liposuction and maybe some fat transfer looks like a likely recommendation.

Give it at least 6 months to heal.  At that time, if the areola need revision, you can seek out a plastic surgeon to reduce the size of the areola.  John T.
Nguyen, MD, FACS, FICSDouble Board
Certified Plastic Surgeon

I would recommend waiting one year after your surgery before having an areolar reduction procedure. This can even be done under local anesthesia in the office. I prefer to use a permanent Gore-Tex suture (deep) to prevent future widening of the areola. Be patient for now, this can be improved.

Best wishes,

Dr.Bruno

You may need to have an areolar reduction to improve the appearance of your areolae.  Visit with a board certified plastic surgeon for your next procedure.

Revision of gynecomastia surgery is not uncommon. This is because quite frequently the two sides are not symmetric to begin with and may have differing amounts of fat and glandular (breast) tissue.

From your photographs there are definitely several things that can be improved.  The size of the areola can be reduced, but it looks like it may have been placed back on as a skin graft.  That complicates the staging of your procedure.  You have significant areas of flatness of the left chest wall as well which could benefit from fat grafting.

Correcting verly large areola following gynecomastia surgery is possible, but is a very difficult problem to repair. Most likely, you will need to wait 6-12 months for everything to heal. You will certainly require areolar reduction, however your chest wall appears to be deficient of skin in the surrounding tissue. You are a unique case, and you may actually require tissue expansion of the surrounding skin, followed by reduction of the areolar tissues.

My first comments would be that your results are not typical for this type of surgery. Combined procedures of liposuction and excision of breast tissue are common and in selected cases a reduction of the areolae can greatly improve the appearance of the breast. For many patients who have more severe gynecomastia, stretched skin or very dilated areolae a staged approach will achieve better results. SmartLipo or VASER lipo is often a very useful adjunct used along with excisional surgery to treating more challenging problems such as what yours appears to have been.

The only option for you at this point is to allow all of your scar tissue to mature for about 12 months and then see a qualified Plastic Surgeon in Australia who can consider options to improve things for you. I do not think that your areola will decrease in size but the scars will fade and some of the contours will improve with time. Your's  is an example of the importance of taking the time before you have surgery to feel that your expectations are in alignment with what surgery can do and that your surgeon is qualified and experienced in managing gynecomastia.

Good luck,

Dr. Mosher

Hi gypo4life86,Thank you for the post and photos. You will need a revision of the areolas to reduce the size but should wait at least 1 year.  Rarely do I perform areolar reduction at the same time as gynecomastia surgery as there is an increased risk of disruption of the circulation to the nipple and areola. In addition to this there can be an increased risk of sensation loss as well. Sincerely,Dr. Dadvand

Judging from your pictures, I am afraid that the chest skin is “too tight”
to allow for a “simple areolar reduction”.  Removing more areolar skin would most likely not solve the problem, and
could lead to greater distortion.  Generally speaking, the size of the areola has more to do with the
amount of surrounding chest skin that can be pulled inward towards the nipple than
anything else.  Trying to close the tight
chest skin to a smaller sized areola would probably just lead to a widened scar
and little if any reduction in the of the areolar size. In order to obtain a good result, I believe that the chest skin should be
“expanded” by placing special inflatable balloons under the skin, and slowly
blowing them up with saline over a period of months.  Once there is enough skin to pull in toward
the nipple, the expanders are removed and then the excess areolar skin and “stitch
marks” around the areola could be removed, and the chest skin closed to a
smaller areola with no tension.  This technique, called "tissue expansion" is often used in breast reconstruction following mastectomy, and also in treating extensive burn injuries.I hope this advice helps.  Good luck!