What is this Hard Tissue After Gynecomastia Smart Lipo?

I had a gynecomsatia smart lipo 4 weeks ago, i can see that my chest has gotten smaller (one side more than the other). but i still feel swelling and hard tissues under the skin which did not exist immediately after the surgery. The doctor did suction out the fat after the liposuction (600cc). Will i still see improvement? is it too early to judge?

Doctor Answers 13

Male breast tissue surgery

usually, when using liposuction alone for removal of gynecomastia, it is only successful if there is very little gland and mostly fat. The more gland there is, the greater the chance of needing both liposuction and surgical removal at the same time. At his point in time, with your case, it can be the tissues that were not removed being traumatized from the SmartLipo and they will get better, it can be some degree of scar tissue that has developed and will get better in time, or it can be residual breast gland that the SmartLipo could not remove. Either way, it is too soon to make a decision, give it a couple of months for the tissues to settle down and then a more accurate determination can be made.

Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Hard tissue after gynecomastia smartlipo

The hard tissue is probably residual breast and fibrous tissue. Smartlipo and other forms of liposuction will not usually get this out. if your surgeon did not specifically excise this, it will probably remain. You won't know for sure until about 3-4 months after surgery.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 78 reviews

Swelling and Scar Tissue.

All liposuction, especially smart lipo creates scar tissue.  The heat from the device and the trauma created causes this effect.  This is normal.  The swelling will reduce as the tissue heals and the scar tissue matures.  However, if you have true gynecomastia the liposuction will not remove the gland and it will remain.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 76 reviews

What is this Hard Tissue After Gynecomastia Smart Lipo?

Either residual breast gland, scar, blood collection. are the options. Time will tell which one it is, like at least 2 months post operative. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Gynecomastia Surgery

Thank you for the question. 

Yes, it is  too early to judge the final results of the surgery. The “hard” tissue you are feeling is either swelling in the tissues that will dissipate with time for residual breast tissue  after the liposuction procedure.

Generally speaking, I have found that gynecomastia is often best treated with  partial excision of the prominent glandular tissue  as well as liposuction surgery of the peripheral chest area.  If the prominence of the chest wall is caused by adipose tissue, then liposculpture surgery alone may suffice.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews


Gynencomastia can be due to increased fat and increased breast tissue. Surgery involves removing the excess breast tissue and liposuction in any form and method to decrease the fat and get a better result.

What you might be feeling is breast tissue that was not taken out. Or you are feeling fat necrosis,

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

Gynecomastia treatment requires liposuction and surgical removal of Breast Tissue

Liposuction only removes fat of male breast fullness.  Gynecomastia is combination of fat and breast tissue.  Breast tissue excision is required in addition to liposuction for adequate treatment.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Swelling After Gynecomastia

This is a difficult question to answer without seeing you directly. Firmness can be scar tissue, swollen tissues, a fluid or blood collection, residual glandular tissue, or a number of other things. My best advice would be to revisit your plastic surgeon to make sure things are progressing normally. In some cases, if a physical exam is not enough, an ultrasound can be helpful to assess what is going on under the skin.

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 53 reviews

Hard Tissue After Smart Lipo

Hi Mike528,

Thanks for the post.  At 4 weeks you are still early in the healing phase. Liposuction rarely is enough in cases of true gynecomastia, when there is excess glandular tissue. These require excision of the tissue to obtain the best contour. The fact that you didn't see or feel this hard tissue right after surgery suggests that it is likely scar tissue. There are massage techniques that may help. I recommend you contact your plastic surgeon regarding this.


Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 46 reviews

Reassess in a couple of months

I suggest you wait a couple of months then reassess your results. The lumps may be removed with revision surgery, if necessary.

Michael Constantin Gartner, DO
Paramus Plastic Surgeon
4.7 out of 5 stars 140 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.