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

Question

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.

Kenneth Hughes, MD · Answer

Fat grafting is probably the most reasonable treatment.Find a plastic surgeon with ELITE credentials who performs hundreds 
of body contouring procedures and male breast reductions each year.  
Then look at the plastic surgeon's website before and after photo 
galleries to get a sense of who can deliver the results.	Kenneth Hughes, MD Los Angeles, CA

Alexander Q. Ereso, MD, FACS · Answer

Sorry to hear you are having issues concerning your surgical results. The unfortunate crater deformity occurs after the removal of glandular tissue in the central area combined with inadequate contouring of the surrounding tissue. Your complaint of the crater being more prominent in certain arm positions is especially important as performing the operation with the arms in different positions may worsen a crater deformity when the patient moves his arms. The ability to contour the chest to create a smooth appearance is just as important as the adequate removal of the glandular tissue. Experienced plastic surgeons know that what is important isn't so much of how much tissue was removed, but rather, the tissue which is left behind which leads to a smooth, contoured chest. I usually correct a crater deformity thru fat grafting. With the improvement in fat grafting techniques and increased fat viability, structural fat grafting can be considered far and away the mainstay for correcting contour deformities after surgery. My advice is to seek out an experienced, board certified plastic surgeon who is affiliated with the American Society for Aesthetic Plastic Surgery (ASAPS).

Jed H. Horowitz, MD, FACS · Answer

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.

Luis Macias, MD, FACS · Answer

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.

Steven Wallach, MD · Answer

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.

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

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

Answers (6)

Answer: Contour deformity after gynecomastia surgery

Answer: Contour deformity after gynecomastia surgery

Answer: Gynecomastia and adherence

Answer: Gynecomastia and adherence

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Our mission is to create a world where every investment in modern beauty is Worth It.