Gynecomastia surgery 6 months ago - will my nipple look identical? (Photos)

Question

Dear Doctors, I had my gynecomastia surgery about 6 months ago and unfortunately on the right side my nipple doesn’t look the same. Actually it’s barely visible i was worried in the beginning and my doctor recommended to use HA filler but then he said we just need to wait longer. I am very concerned. Could you please share your professional opinion? Thank you!

Daniel Barrett, MD · Answer

Dear adamsp92,
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

Ajaya Kashyap, MD · Answer

Thank-you for your question. The nipples and the tissues can take up to one year to completely settle down. I would recommend vigorous massages at this time. If the problem does not resolve at the end of one year, you may consider some fat or filler injections. All the best!

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures.
If you don’t have before and after pictures then ask your surgeon to forward the ones they took.
Some asymmetry is always going to be the case. Surgery is an imperfect science.
The degree to what degree of asymmetry is in the end acceptable and what is not it’s going to vary from surgeon to surgeon and from patient to patient.
Knowing what you look like before the procedure would be helpful to see if there was an overall significant improvement.When reducing mail chests with large amounts of the bulking the chance of having minor asymmetry is going to be increased.
If the procedure was relatively subtle with only small amounts of tissue removed then more improved symmetry and then overall better outcome would be appropriate.
When it comes to removing glandular tissue surgeons should generally lean slightly on the conservative side.
You can always go back and take a little more tissue out.
Over resection of glandular tissue is extremely difficult if not impossible to correct.
It would also be helpful to know exactly how your procedure was performed.
Was this only done with Liposuction or was there also an open excision of glandular tissue?
Typically breast tissue cannot be removed with Liposuction and requires direct excision with a scar that’s placed as a semi circle around the areola on the lower half.
When doing that surgeons should leave a certain amount of glandular tissue attached to the skin to guarantee or minimize the chance of over respecting that tissue.
I don’t see the scar on your areola so I’m guessing this was done with only using aggressive liposuction.
Did the provider use energy-based equipment like VASER?
The two sides are slightly different. It would help to know which side do you like better and if you are content with one and not the other side.
Regardless at six months you can consider your results final and waiting longer isn’t going to make your outcome any better.
The only thing that will be improved with time is the color of the skin incision where the liposuction was done. that scar will continue to fade for at least another six more months.
Adding tissue is not going to be easy or successful but if there are areas of fullness then more tissue could be removed if that helps.
In the end your surgeon is responsible for the outcome of the procedure and you are responsible for choosing that provider.
Gynecomastia surgery is not the easiest procedure to do and patients often complain of insufficient outcomes so there is some overhanging pressure for surgeons to be heavy handed.
In the end there are three tissue variables that contribute to the fullness of the male chest. They are skin laxity, subcutaneous fat and glandular breast tissue.Your skin looks good so in the end it is a combination of fat and glandular tissue.
That can be removed with Liposuction about glandular tissue is best removed with a direct open excision. This is more precise and effective.
If too much tissue has been removed it is been a challenging situation but has few really good options.
HA fillers may work but is an unacceptable long-term strategy since they will only last six months at best.
To get a proper second opinion I suggest you schedule those as in person consultations with local board-certified plastic surgeons. For second opinion consultations I recommend having prepared bringing with you proper before and after pictures and a copy of your operative report. These are all available from your surgeons office if you ask for them.
It’s a little difficult to make an assessment based on limited information. We also don’t have the privilege of hearing exactly what you like and what you don’t like about the outcome.
While gynecomastia surgery is not the easiest procedure to do a time to focus on provider selection is generally before surgery.
It’s surgeon will have their own way of doing things. I generally recommend patients have multiple in person consultations before scheduling surgery. During each consultation ask each provider to open up their portfolio and show you their entire collection before and after pictures. providers may be apprehensive to do this and will instead prefer to show you pre-selected pictures representing some of their better results.
This is however insufficient to get a clear understanding of an average results look like or how many of these procedures they’ve actually performed.
When it comes to reviewing before and after pictures patients should come armed with pictures of their own body to use as a reference.
Candidacy for the procedure will vary from patient to patient.
When reviewing before and after pictures it’s important that you are seeing previous patients who had similar body characteristics to your own.
As I mentioned earlier there are three tissue layers that can contribute to this problem. They are skin laxity, subcutaneous fat and breast glandular tissue.
I suppose after the procedure there isn’t much point in talking about how to select surgeons but the exception comes if you’re going to have a second opinion with another surgeon and doing a revision work.
If that’s the case then you need to go through the vetting process one more time.
For reference I usually tell people that an experience provider should have no difficulty showing you at least 50 that’s a before and after pictures. Well gynecomastia surgery is not the most common plastic surgery procedure it is certainly not uncommon.
For common procedures plastic surgeons should in fact have hundreds of before and after pictures.
For gynecomastia surgery he would hope an experienced surgeon should be able to put together at least 25 to 50 sets of before and after pictures for you to look at. Hopefully some of those have very similar body composition to your self so you should get a good idea results look like including the degree of asymmetry or contour irregularities. 
Ask provider specifically to show you examples of excellent results, average results and results that did not turn out as well as they had hoped. we all have a variety of outcomes and it’s certainly fair game for patients to ask to see them.
Again, surgeons may be apprehensive to show you anything other than their preselected “best of their career” results.
Most people do not have much experience consulting with plastic surgeons or vetting plastic surgeons regarding the skill and experience.
Being board-certified and plastic surgery with years of experience in an overall good reputation does not mean somebody is necessarily good at their job nor that they have a mastered any one single procedure.
In the end patients need to take it upon themselves to properly vet providers and find the most qualified provider in their community.
I generally recommend patient start by having five in person consultations and consider schedule anymore unless they feel very confident they found someone with sufficient skill and experience.
I recognize this is a bit after the fact but like I mentioned earlier if you’re going for a second opinion you’ll need to go through the vetting process one more time.
I’m not sure anybody is going to give you any particularly useful information other than following up with your provider.
And in person consultation would certainly go a whole lot further in regards to understanding what you’re trying to achieve and you intern hearing from each surgeon what they can or can not accomplish.
Hopefully the overall result is better than what you’re started. Like I mentioned earlier you should always include before and after pictures so we have some idea of where you started.
Best,
Mats Hagstrom MD

David E. Berman, MD (retired) · Answer

i would wait a year to see how much it self corrects and I think it will continue to improve. you may have to accept that there will always be some difference between the 2 sides.

david berman md, frcsc

Gynecomastia surgery 6 months ago - will my nipple look identical? (Photos)

Answers (4)

Answer: It looks like your right areolar complex experienced some trauma from your surgery

Answer: It looks like your right areolar complex experienced some trauma from your surgery

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Everything you need to know about Gynecomastia Surgery

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Gynecomastia surgery 6 months ago - will my nipple look identical? (Photos)

Answers (4)

Answer: It looks like your right areolar complex experienced some trauma from your surgery

Answer: It looks like your right areolar complex experienced some trauma from your surgery

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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.