Is there still gland or it may be scar tissue? (photos)

Dear Rational276410,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thank you for your question regarding whether there's still a gland or perhaps scar tissue behind the nipple region after gynecomastia surgery which included the removal of the gland and liposuction seven months ago. Your pictures and history suggest you probably have scar tissue in this area. If you are overly concerned, you may consider obtaining an ultrasound or CT scan from this region. If there is further granular or scar tissue, this may be admirable to a reoperation. Caution must be given about having a revision of gynecomastia. If too much tissue is removed, you have an even more difficult problem to solve. If too much tissue is removed, you may require fat transfer to correct the defect or even pectoralis implants.
In conclusion, I think that you have scar tissue. If you are overly concerned, consider a radiographic examination. However, if you are considering revision surgery, please seek multiple opinions. Thank you for your excellent question regarding whether there's still a gland or perhaps scar tissue behind the nipple region after gynecomastia surgery, which included the removing the gland and liposuction seven months ago.
Sincerely,
Dr. Katzen

Thank you for your query. When a Gynecomastia surgery is done a very small “button” of tissue is usually left right beneath the nipple, so that it does not sink in and produce a deformity. It is possible that a little more tissue than needed was left behind. It is also possible that you have scar tissue, but less likely. Please visit you plastic surgeon, have him examine you and address all your concerns. All the best!

Dear Rational, It is impossible to answer your questions without a physical exam to feel and assess what is there. Please see your surgeon again to be evaluated.

Most gynecomastia includes both gland and fat. If liposuction only was done, some gland may still be present.

To make an accurate assessment on the outcome of a procedure, we need to see proper before and after pictures. If you don’t have before, and after pictures, didn’t ask your surgeon to forward the ones they took.
The mail chest and its appearance is generally determined by one or more of three different variables. The variables are glandular breast, tissue, subcutaneous, fat, and skin laxity. Scar tissue forms after any surgical procedure, but just should not create excessive volume if the procedure is done correctly. It is inappropriate to remove all glandular tissue since that will leave a deforming indentation or defect.
A good way to help assess which tissue is contributing. The most is to put both the skin and pectoralis muscle under tension one side at a time. Do that by stretching each arm one at a time behind your head like you’re scratching your upper back.
With the arm behind your head, having the pectoralis and skin under tension, you can see the contour of both subcutaneous, fat and glandular tissue clearly.You can then watch the contour of your chest and see how it changes when you put your arm down and this last part represents how much skin laxity is contributing.
Young men who have not had major weight fluctuations, should not have issues with skin laxity, but older individuals, or men who have had weight fluctuations, even as low as 20 pounds can have skin laxity issues that can contribute significantly.
Gynecomastia surgery, including making accurate and predictable assessments. It’s not always easy or straightforward. Patients should be careful in selecting the best providers by having multiple in person consultations. Since you’ve already had surgery, your options are to follow up with your provider or schedule a second opinion in person consultations with other plastic surgeons. Since you didn’t include before, and after pictures, we can’t really make an assessment regarding the outcome of your procedure. What you look like now doesn’t tell us the outcome of the operation since the operation represents the difference in appearance from before and after i.e. delta.
Best,
Mats Hagstrom, MD