Solution for stretched areolas with hypertrophic scarring after gynecomastia surgery? Unresponsive to steroids with CO2 (photos)

Question

29y old M, black, generally healthy. I had bilateral gynecomastia surgery with gland excision, liposuction and areola reduction via circum-areola incisions. At 2 weeks, bandages removed, then surgical dehiscence on one side. My chest felt tight for about 6 weeks. I could not raise my arms or sleep on my sides. The side that dehisced now has a hypertrophic scar unresponsive to 3x steroids with CO2 laser. Chest still flat, but both areala appear stretched. Slight indent when arm raised. Help?

James Lee, MD · Answer

Thank you for your question and submitting your photos. I'm sorry to hear that you developed bad scarring during your healing process. Steroid and laser can help with scarring. Silicone based ointment or scar sheets can also help flatten and decrease pigmentation of your scars. Scars will also continue to mature for 1 year so if you are still relatively early in your recovery period, there is still time for the scar to mature further. As a last resort once all modalities have been tried and it you have given your body adequate time (minimum 1 year) for the scars to mature, a scar revision can be looked at. That being said, if you are prone to hypertrophic/keloid scars, it is always possible that they recur. Hope this helps. Be sure to consult with a board certified plastic surgeon for all you concerns.

Daniel Barrett, MD · Answer

Dear Calm73590,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jaroslaw Tribull-Potapczuk, MD, PhD · Answer

I answered this question allready, but I do not see my answet here. Therefore I just try again: The scars are rather distended than hypertrophic. Therefore local steroids will not help (even opposite efect possible). The scars must still "ripe", which process may take severel weeks or even months. Then all the therapy options may be discussed, but the surgical option is most probable.Best regardsDr. Tribull, Berlin, Germany.

Mats Hagstrom, MD (license on probation) · Answer

Applying the same areola reduction we do on female surgery on a regular basis tends to not work out very well on male gynecomastia surgery.
Your outcome is somewhat predictable by using that technique.
Attempting a revision and redoing the same procedure is likely to lead to the same result. 
To do a proper reduction will add scars to your chest but allow the Ariolas to remain small.Trying to find a plastic surgeon who has done a lot of chest lift procedures on men with a proven track record based on an impressive collection of before and after pictures otherwise leave good enough alone.
Best,
Mats Hagstrom MD

Solution for stretched areolas with hypertrophic scarring after gynecomastia surgery? Unresponsive to steroids with CO2 (photos)

Answers (4)