9 months after gynecomastia. Did it come back? Would I need a revision? What went wrong? I wore vest all the time. (photo)

Nine months ago I got gynecomastia surgery done. 500cc of tumescent fluid were injected to both sides of chest. 500cc were aspirated from both sides. 400cc of those 500 were fat( each side). Then my surgeon made a periareolar incision to both sides and said there was no gland to be removed. Now 9 months later my chest looks like this. I have a feeling the glands are still there plus maybe loose skin? I am very disappointed. What can be done to accomplish a flat chest with no puffy nipples?

Doctor Answers 7

When to Consider Gynecomastia Surgery Revision

The areas after Gynecomastia Surgery may feel “lumpy” or irregular, and should decreases with time. Often massaging these areas will help soften the scar tissue. Also, 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 that any indentations could be addressed with fat grafting or cosmetic filler(s) if eligible.

Typically, its best to wait at least one year following the initial surgery to consider a #revision. It is imperative you select a plastic surgeon who is #board-certified and has a great deal of experience with male breast #reduction. Plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your procedure. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Please be advised that each patient is unique and previous results are not a guarantee for individual outcomes. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Unhappy after Surgery

Thanks for the post and photos. You will need a revision. Based on the photos you likely have breast tissue under the areola causing the protrusion. This is why liposuction for most will not completely treat true gynecomastia when there is glandular excess. You are far enough out from surgery where a revision can be done with good success.

Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 44 reviews

Disappointed with gynecomastia results

Thank you for the pictures. It looks like to me that you need more aggressive liposuction and glandular removal. I know your surgeon said that there wasn't any gland to be removed but I wonder about that. Please seek second opinion consultation from board certified plastic surgeons.


Gynecomastia can be a bit tricky and not uncommonly it is staged. I often do liposuction first.  In your case, you may have a bit of parencymal tissue left which may need to be excised and you might need a small areola reduction.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

9 months after gynecomastia. Did it come back? Would I need a revision? What went wrong? I wore vest all the time. (photo)

You are correct that there is still some glandular tissue remaining under the nipple-areolar complex and some residual loose skin.  This is not unusual after liposuction-only treatment for gynecomastia.  That does NOT mean that the original treatment was incorrect.  We very often  prefer liposuction as the first alternative knowing that it might not achieve a perfect result.  It is less expensive than more invasive options, less expensive, and there is no noticeable scarring. We can always go back to finish up. 

That being said, you will need removal of the remaining gland.  That is relatively straightforward, but will require an incision/scar around the bottom of the areola. If you want the skin tightened and the areola made smaller that can be done as well, but will require and incision/scar all the way around the areola.

Good luck.

William A. Terranova, MD
Charleston Plastic Surgeon
5.0 out of 5 stars 9 reviews

Revision of gynecomastia

Just by reviewing your pictures and without actually feeling what's underneath the nipple I'm guessing that there's still some parenchymal breast tissue underneath the areola. There may likewise be some skin redundancy. You may need a small touchup revision to reduce the sub areolar breast tissue. I recommend that you go back to your operating surgeon and let them examine you and make recommendations. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

9 months after gynecomastia. Did it come back? Would I need a revision? What went wrong? I wore vest all the time.

From my review of all the series of your posted photos my over the internet guess is a N/A revision with reduction is needed now......

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 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.