Recently had gynecomastia surgery. Do I need to pay additionally for excision even though it was supposed to be done? (Photo)

I just recently had gynocmastia surgery (via Lipo) I don't believe my surgeon performed a glandular tissue removal though. It has been two weeks, which I know is still to early but I still have "breast". When I flex my peck muscles the top is hard muscle but right above the nipple to the bottom of my breast is still "breast like". I feel little ball like tissues underneath my skin. Will I have to pay even more money to have this done even though it should have been done in the first place?

Doctor Answers 7

Two weeks postop and gland removal

 Two weeks is still indeed very early in the healing process and it is difficult to determine results based on swelling. For this particular instance it is best to consult with your surgeon to confirm that Glenn removal was in fact done during surgery. If there were some kind of miscommunication  surgeon will have their own policy on how to proceed.  If you were to have a revision surgery it would be best to wait at least six months before considering this  

Orange County Plastic Surgeon
5.0 out of 5 stars 107 reviews

Early results after gynecomastia reduction

Your results will improve with time. That is the good news. But if your surgeon did not complete a glandular excision, you may indeed have less than ideal results. If your preop discussion and understanding was that an excision was to be completed and it was not, I would have a conversation with your surgeon to determine if a revision procedure should be completed at minimal of no cost. Every surgeon is going to have their own policy on this type of situation. Best wishes. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 84 reviews

Gynecomastia lump after chest liposuction

Hi Chris,

Thanks for your question and photos. Based on your preoperative photos you have some residual fat based on the pinch test that you performed. It may just be swelling and inflammed tissue. I would recommend waiting till atleast 2-3 months after surgery. If it remains you may need more liposuction and gland removal. This discussion should have been done by your surgeon BEFORE the operation so that expectation would be met from both sides. You usually there may be a fee for a touch up or if the surgery needs to be redone, then facility and anesthesia fees may be charged.

I would wait 3-6 months before final judgement is made. Discuss with your plastic surgeon your concerns. We are always trying to make our patients happy. Good luck.

All the best,
Carlos Mata MD, MBA, FACS

Carlos Mata, MD, MBA, FACS
Scottsdale Plastic Surgeon
5.0 out of 5 stars 30 reviews

Recently had gynecomastia surgery. Do I need to pay additionally for excision even though it was supposed to be done?

Way too early to tell what may be residual gland vs fat necrosis(from lipo) vs. swelling.
Once you feel your healing changes have stabilized,  have your surgeon reevaluate your result.

Offices have individual policies with respect to revisional surgery.
Did you and your surgeon specifically agree that the gland would be removed?
Was a periareolar incision discussed??
Or was the plan(reflected in the fees) for lipoplasty only??

If you have paid for glandular removal it should be done at no additional charge, however, if 
no specific discussion occurred I would suggest a open honest conversation with your surgeon.
Communiction is critical.

If your procedure was done in an office-based surgery center there is more latitude for negotiation, if however, it was performed in a surgery center or hospital, fees for the OR an anesthesia must be paid.
If your surgeon did not do what was agreed upon perhaps he/she can help pay these fees.

It all comes down to what was agreed up.
If there was a misunderstanding, communication and compromise is the best approach.

There used to be a revisional surgery insurance; not sure if it still exists, however, it would be a great idea at the right price.

Hope this helps

Andrew Kornstein, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 15 reviews

Please be patient!

If you feel there is still a problem after 8-10 weeks, let your surgeon know.  If any tissue remains, it could likely be removed in the office.  I do not charge for this kind of revision.  Best of luck, and be patient! 

Nicholas Husni, MD, PhD, FACS
Cleveland Plastic Surgeon
5.0 out of 5 stars 6 reviews

Gynecomastia and surgery

I usually discuss this up front with patients. I will often perform liposuction if I think the chest will improve with this. If often delay direct excision and see how the lipo heals. There are additional fees for the excision in my practice.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Gynecomastia post op

If your "recent" surgery was within the past 8-10 weeks then most of what you feel is probably the thick firm liposuction swelling that does not completely go away for 12 weeks or longer. You need to have this discussion with your surgeon. They are in much better position to explain what they feel and observe, and if revision is necessary, what costs are involved.

Scott W. Vann, MD, FACS
Savannah Plastic Surgeon
5.0 out of 5 stars 4 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.