Could this be over resection and/or scar tethering and what are my options? (Photos)

Question

I had mild gynecomastia surgery 8 months ago, I feel the surgeon took too much gland. I had waited 20 years for this surgery and i kind of wish I hadn't had it done now. One of my areola is creased and the other just looks too flat. When I lay on my back or raise my arms my nipple sinks in. I just wondered what my best options would be to fix this and what the chances are for it to be successful. Thanks in advance. I have provided before and after pics.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  It appears that you have overall healed well and should see continued gradual improvement with time.  If the creasing or indentations remain after a year's time I would recommend fat grafting into the area to help increase fullness underneath the nipple to minimize the indentation.  Hope this helps.

Robert M. Tornambe, MD · Answer

TomSorry you are having these issues after gynecomastia surgery, and physical examination would be helpful to provide a more detailed answer and recommendation. However it appears from your photographs that fat grafting may address your concerns quite adequately, especially around your nipple regions. Consult with a board-certified plastic surgeon in our area for a full evaluation. Good luck.

Matthew A. DelMauro, MD, FACS · Answer

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) Based on your photos, the nipple/areola may not have sufficient support underneath it (compared to the tissue around it; due to the tissue resection) and/or may be tethered to deeper structures due to scarring. (A physical exam is necessary to delineate the cause of your condition.) Treatment will depend on the cause. For instance, if a scar is tethering the nipple/areola to deeper structures, a scar release (with or without fat transfer) may be a good option to improve the dimpling. Scar revision surgery may also be a good option to improve the appearance of the scar on your chest. You should schedule an appointment with your plastic surgeon so that he/she can address your concerns, examine you, and develop a plan of care. Best of luck!
Matthew A. DelMauro, M.D.

David E. Berman, MD (retired) · Answer

Please realize that you are much more aware of this, than it is noticeable. i would wait until you are a full year from surgery. at that point, see a board certified PS and consider fat grafting.david berman md

Could this be over resection and/or scar tethering and what are my options? (Photos)

Answers (4)