Gynecomastia revision vs nipple reduction? Nipples went from pointy puffy to pointy saggy (Photos)

Question

I had surgery for mild Gynecomastia 10+ years ago. I am happy how my chest looks, however, my nipples still bother me because they still show when I wear t-shirts. My nipples went from pointy puffy to pointy saggy. My concern is areola does not sit flush with my skin, perhaps too much excess areola skin? I am questioning if he removed enough gland. I am considering revision vs nipple reduction. If I do revision, I am worried it may cause a crater. Whereas a nipple reduction may help slightly.

Paul M. Pearce, MD · Answer

Not knowing the manner in which your gynecomastia surgery was done makes it difficult to give a good answer. But, it looks as though your areolas are the appropriate size. It might be possible to take a very small amount from below the areola or possibly to make an incision along the inferior border of the areola to remove a small amount of excess skin and possibly flatten it out. There are also some newer techniques to help make the areola smaller with less scarring than what an areola reduction can cause. Be sure to talk with your surgeon about your concerns. You do have a good result now and any aggressive plans for revision could easily push your result over toward a poor result. Less is more in your case.

Mats Hagstrom, MD (license on probation) · Answer

It’s rare that going to come as your surgery outcome comes out exactly perfect.
It’s usually a balancing act between not removing enough tissue and removing too much.
I’m guessing your surgeon was a little over aggressive with the tissue in the lower half. 
It’s not necessarily an easy or straightforward procedure.
Some tissue needs to be left in order to not create an indented appearance.
At the same time, patients are quick to complain if they see any fullness after surgery. I would probably not recommend removing more glandular tissue.
You can reduce The nipple size, if desired.
I really recommend people avoid virtual consultations whenever possible, and instead always rely in in person consultations so the provider has the benefit of an examination.
It’s much easier to see the contour of the soft tissue chest coverage if you put your skin and pectoralis muscle under tension, one side at a time by putting your arm over your head like you’re scratching the upper part of your back. do that and have someone else take pictures or use the timer on your camera.
With the skin and pectoralis muscle under tension, you’ll see the outline of the glandular tissue and any remaining subcutaneous that much better.
With age people develop slight skin laxity or loss of skin elasticity, and this can also create some fullness in the lower part of the chest.
By putting the skin under tension, individuals can get a better understanding of how much skin is contributing to chest contour. When making an assessment, we need to look at skin, subcutaneous, fat, and glandular breast tissue. They are the three components that can give fullness in the Male chest.
To make a quality assessment, we should also ideally have access to before and after pictures.
If you have them always include them.
If you don’t have them see if the provider who did your procedure is still in practice and still has your medical records.
If they do then get copies of your proper before and after pictures.
While you’re at it, you should also get a copy of your operative report, which would be good for any surgeon doing revision or secondary procedures.
Best,
Mats Hagstrom MD

Gynecomastia revision vs nipple reduction? Nipples went from pointy puffy to pointy saggy (Photos)

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Everything you need to know about Gynecomastia Surgery

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Gynecomastia revision vs nipple reduction? Nipples went from pointy puffy to pointy saggy (Photos)

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Everything you need to know about Gynecomastia Surgery

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