Should I Go Back to the Same Gynecomastia Surgeon for the 2nd Time?

Thanks for the question. If necessary, gynecomastia can be repeated 1-2 times depending on the operation area. I wish you all the best.

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.

If the gland was excised, it shouldn't come back.  Liposuction alone is inadequate to correct gynecomastia.  If gland was excised, have you gained weight?  Tough to tell without more info.

Recurrence or residual gynecomastia is a risk of gynecomastia reduction surgery.  I recommend at least consulting with your first surgeon and communicating your concern.  Good luck
and be safe.John T.
Nguyen, MD, FACS, FICSDouble Board
Certified Plastic Surgeon

Breast tissue recurrence after surgery does happen.  It does not mean it is the surgeons fault.  The gland that is present may become stimulated for what ever reason and start to enlarge. We surgeons never go in to surgery to take out all of the gland but we consider this a cosmetic procedure to create a good looking chest and not a cancer operation taking all of the breast tissue out.  You can have a deformity like a crater.

You can discuss with your doc but you may want a second opinion.

I would recommend going back for a second consultation to discuss the planned procedure. If Liposuction alone were used, the surgeon will now know that excision of the gland may be a better option. Ultrasonic liposuction techniques were very popular many years ago and we thought we could treat gynecomastia with this alone. We have discovered that the vast majority require excision for an optimal result.

Hi Boise1294,Thanks for the post. My answer is prefaced on the idea that your initial surgery involved resection of tissue and not just liposuction. Although you don not regrow breast tissue, there may be residual breast tissue that for some reason has become re-stimulated. The purpose of gynecomastia surgery is not to necessarily remove 100% of the breast tissue, but to remove enough to give a good, natural chest contour. I would recommend going back to the original surgeon if you have a good rapport with him/her and have faith in their ability.Sincerely,Dr. Dadvand

I have treated a number of patients who have previously undergone gynecomastia surgery and felt that their results were not ideal, and who came to this practice seeking an improvement of their chest area appearance. The most frequently encountered problems are the following:

Liposuction only was performed, leaving behind a mass of breast tissue behind the areola.
Over-resection of breast tissue behind the areola resulting in nipple retraction, areolar indentation/depression, or chest area surface irregularities.
A deflated appearance from excessive tissue removal.
Unfavorable scarring from skin excision procedures.
It is obviously a very difficult and frustrating experience for a man to seek surgical improvement of a problem area that keeps them from being comfortable without a shirt on, and to end up with a post-surgical problem that leaves them with the same situation. The good news is that essentially all unfavorable results from prior gynecomastia surgery can be improved with careful preoperative evaluation and re-operative treatment planning.

The improvement of unfavorable results may require any number of surgical techniques including additional adipose and/or breast tissue removal, replacement of tissue using structural fat grafting and/or dermal-fat grafts, revision of scars, and removal of excess skin. While in some cases there are inherent limitations to the degree of improvement that is possible, most problems can be improved dramatically and some can be completely corrected.

It is unlikley but not impossible to have a recurrence.If you have an experiencee  gynecomastia surgeon, and you like him I would consider using him again. The Surgeon's web site may give you indication about his experience and his before and after photos may help you to make this decision.

I would definitely recommend going back to your original surgeon.

If you have recurrence you probably didn't have the glandular fibrotic breast tissue removed and only the fatty breast tissue removed.

You most probably need a mastectomy to improve on that. See the surgeon first and see if he would do that for you since you already paid for it the first time.

Find a new surgeon if your surgeon originally was not experienced with this procedure or you feel unsafe or uncomfortable with him!!

Good luck!