What are my options for gynecomastia revision surgery?

Question

I had surgery to remove my unilateral gynecomastia two and a half years ago. I did it through my insurance, and so it was not a specialized plastic surgeon doing my surgery. As you can see from the picture, she removed the gland through a fairly large excision close to my armpit. There is a fair amount of scar tissue around the area where the gland was, and a slight "crater deformity". Is there any hope for improved symmetry? Or at least a reduction in puffiness/ actual nipple size (not areola)?

Tim Neavin, MD · Answer

Thanks for the photo. The scar can be improved, as well as your overall cosmetic result.  Be sure to see a board certified plastic surgeon.  One that does a lot of gynecomastia cases is a plus.

Jose M. Soler-Baillo, MD, MS · Answer

Thank you for your question and pictures.  Your scar can be fixed by scar revision surgery.  You do not seem to have too much nipple puffiness nor do they seem to be too large.  If you do feel that reduction in puffiness and size is necessary, please see a board certified plastic surgeon who specializes in this type of surgery.All the best,Dr. JSB

Robert M. Tornambe, MD · Answer

Sorry you are having this problem. It appears that scar revision and possibly fat grafting would benefit you. Seek out a board certified plastic surgeon and check out the link below to an article I wrote about Gunecomastia. Good luck!

Ajaya Kashyap, MD · Answer

Thank you for your question.I would advise some fat injections for restoration of the contour and scar treatments for the next few months to soften and improve the scaring. Scar Revision, if required, can be done after one year after the initial procedure. All The Best !

Samir Shureih, MD · Answer

Correction of over resection of the breast tissue (Dish deformity) can be repaired. How ever this needs a thorough examination to assess the extent of the problem and the scarring. fat transfer can be an option, but there are several options

Mordcai Blau, MD · Answer

How should I choose a surgeon?Selecting a surgeon is as important a choice as the decision to undergo surgery. Choose carefully. The decision is yours. What follows is some advice to assist in making your selection.1. Experience matters. Choosing a surgeon who has performed over one thousand gynecomastia cases increases the likelihood that they have seen a case similar to yours in the past. Selecting a surgeon whose practice is focused on gynecomastia exclusively is also an indicator of experience.2. Results matter. The more before-and-after pictures a surgeon displays, the better. Pay attention not just to the number of pictures, but whether the surgeon is confident enough to show multiple angles of the same patient.3. Reviews matter. Have patients reviewed your surgeon? Did those patients undergo the surgery you are considering?4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Are they certified by the American Board of Plastic Surgery? Have they authored books or medical journal articles regarding your surgery?We hope these guidelines are of assistance when you are selecting your surgeon. When undergoing surgery, it is very important to be realistic about your expectations. Past results are not a guarantee of future results. Also, revision surgery tends to be significantly more difficult than initial surgery.

Thomas M. DeWire Sr., MD (retired) · Answer

cali,The contour deformity may be amenable to fat transfer for contouring, but you will need to avoid significant weight gain if that is done, as the fat can then enlarge with weight gain. I would not recommend any change in the areola and nipple as they appear normal and as symmetrical with the opposite side as is seen normally. I hope that this helps.

Mark Gaon, MD - Account Suspended · Answer

Unfortunately, this kind of deformity is not altogether too uncommon after gynecomastia resection by some of our general surgery colleagues. Too much tissue is resected full thickness down to the pectoralis muscle which can lead to a contour irregularity and painful scar tethering. The final misstep is not paying attention to the remaining breast and not doing any sort of feathering or contouring to the remaining breast.Plastic surgeons tend to treat lower grade gynecomastia patients with aggressive liposuction alone. If a thick fibrous collection of breast tissue still remains after liposuction, only then is a very small inconspicuous incision made within the areola to directly excise this tissue. Even then, a small amount of tissue needs to be left behind both right under the skin and on top of the muscle in order to prevent scar tethering.To correct the deformity as demonstrated in your submitted photos, you will most likely need a combination of scar release, liposculpting, and autologous fat transfer. Make sure you look for a board certified plastic surgeon in your area who is proficient in these techniques.

What are my options for gynecomastia revision surgery?

Answers (8)

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