Will a second fat graft after gynecomastia surgery improve contour irregularities and have a better survival rate?

Overall there tends to be no rhyme or reason why the fat transfer may work one time or the other. I think it is certainly worth trying again and the outcome is likely to be good. However, you are correct that there may be something inherent in the wound bed preventing the graft from taking. Overall, I think one more round of grafting is not a bad idea, however I would turn to other products like Renuva if fat grafting does not work again.

Dear Tom2011,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Fat transfer is sissy’s a hit or miss procedure. But if it worked on one side it may be worth giving it a second try on the other side

Unless there is a lot of scarring present, the second fat graft has better survival since the scarring that was present is now stretched and thinned with the added volume.