How can the crater deformity be corrected from my gynecomastia surgery? (Photo)

Question

I've had a gynecomastia surgery for gland removal in 2019. However, it has left a significant crater deformity on both sides. What is the best treatment to achieve a smooth, round and fuller contour? Do I need some liposuction around my areolas or instead fat grafting to fill the craters? If filling is required, what is the best procedure: fat injections or using fat flaps?

Scott W. Vann, MD, FACS · Answer

Hard to be sure without examination but it appears that you had the small gland right under the aerola removed but the fat is still remaining in the rest of the breast, giving you the crater appearance. Hopefully this could be corrected by liposuctioning the breasts to give a smooth appearance. I always do the suction first when doing gynecomastia and then excise any remaining gland tissue to give a smooth thin appearance with one procedure. Good luck.

Daniel Barrett, MD · Answer

Dear _Hexagone_,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Tim Neavin, MD · Answer

Thank you for your photos and question.  From the images, it appears that there may be some skin redundancy or possible over resection of some tissue or a combination of both.  Or, the tissue just scarred onto the muscle.  Tough to know for sure.  Sometimes the skin just does not retract as you would expect or hope for after surgery.  I generally use the laser liposuction to help tighten skin in addition to glandular removal when necessary.  Keeping the chest wrapped for at least 4 weeks or more often helps to.  In this particular situation it is possible that the lower portion of the chest or breast area may still have fat and would benefit from liposuction there, as well as some transfer to the areola.  Importantly, I would perform laser on the entire chest and abdomen to help the skin retract.  This is generally easily correctable, regardless of the etiology.

Andrew M. Ress, MD · Answer

On photographs it appears that you have minimal extra skin, good elasticity and a concavity where direct excision of glandular tissue was performed. If this is correct I would perform power assisted and/ or Vaser ultrasonic liposuction to reduce and remove the fatty tissue surrounding the contour deformity. I would also release the scar tissue under the nipples at the level of the muscle and also release the breast crease to allow the skin to redrape like a tent collapsing after removing the tent pole.
Any redundant skin can be addressed at a second staged procedure.

Sanjib Tripathee, MD · Answer

If you are looing to volumize the depressed NAC area, fat graft might be the best option for you. Fat flap is the complicated procedure to perform.

How can the crater deformity be corrected from my gynecomastia surgery? (Photo)

Answers (5)

Answer: Liposuction First

Answer: Liposuction First

Answer: Fat graft

Answer: Fat graft

Recommended reading

Everything you need to know about Gynecomastia Surgery

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How can the crater deformity be corrected from my gynecomastia surgery? (Photo)

Answers (5)

Answer: Liposuction First

Answer: Liposuction First

Answer: Fat graft

Answer: Fat graft

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Recommended reading

Everything you need to know about Gynecomastia Surgery

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