Crater deformity after gynecomastia surgery: repair with fat graft or fat flap? (photo)

I had gynecomastia surgery (excision+lipo) on the right chest about 6 months ago(already the revision of a prior surgery) that left me with crater deformity.With relaxed chest the crater is hardly visible,with arms raised/chest flexed it`s obviously.Already visited another ps to discuss options.He suggested fat grafting.Also did internet-research and read about fat flap technique .Can you tell,when looking at my pics, whether you would recommend fat graft or fat flap to fix this? Tank you.

Doctor Answers 5

Crater deformity after gynecomastia surgery: repair with fat graft or fat flap?

Fat grafting is probably the most reasonable treatment.

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Kenneth Hughes, MD Los Angeles, CA

Contour deformity after gynecomastia surgery

Hello Carl,

I agree with your plastic surgeon that fat grafting in likely your best option for the contour irregularity seen in the photos you provided. Many times 2-3 fat grafting sessions are necessary to fully correct the defect.

Gynecomastia and adherence

Gynecomastia surgery can be very delicate and millimeters of fat differences in the subcutaneous space can cause this problem. Fat grafting is a reasonable option but may require more than one treatment.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Gynecomastia

Based on the pictures posted, there is a significant crater, probably from over-liposuction lateral to the nipple. Fat flap means moving some of the local fat over to the defect. That can be done provided you have enough fat to move without creating another crater. Fat graft involves liposuction of fat from other areas and preparing that fat then transferring that fat to the defect. To correct a liposuction problem may require multiple sessions to get the ideal results.

Samir Shureih MD FACS

sshureih@msn.com

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Healing Concerns & Indentations Post Gynecomastia Surgery

Your #incisions will go through a maturation #process following #Gynecomastia #surgery. For the first few months they will be red and possibly raised and/or firm. As the scar matures, after 6-12 months, it becomes soft, pale, flat, and much less noticeable. You may experience numbness, tingling, burning, “crawling”, or other peculiar sensations around the surgical area. This is a result of the #healing of tiny fibers which are trapped in the incision site. These symptoms will disappear. Some people are prone to keloids, which is an abnormal scar that becomes prominent. If you or a blood relative has a tendency to keloid formation, please inform the doctor.

Bruising and #swelling are normal and usually increase slightly after the removal of any tape or foam. The bruising will decrease over 3-4 weeks, but may last as long as 6 weeks. The majority of the swelling will be gone within the first 3-4 weeks. However, it may take 6-9 weeks to disappear completely. 
Also, as you heal, the area may feel “lumpy” and irregular. This, too, decreases with time, and massaging these areas will help soften the scar tissue. The #compression garment helps reduce the swelling, and the longer it is worn, the more quickly you will #heal. It can also assist in the retraction of the skin. If you have any concerns about #healing, its best to ask questions of your surgeon or their nursing staff. It's possible the indentations can be addressed with cosmetic filler(s) if eligible.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.