Nipple crater after gynecomastia surgery. Is there a way to fix it permanently? (Photo)

Question

Hey it's been almost a year since my operation. 10 months to be exact. As you can see ive got a nipple crater on my right nipple, im also not happy with my left nipple which i still think got som tissue left? It looks terrible. My surgeon told me that this is impossible to fix, but ive seen people with similar problems on this site and it looks like it should be possible to fix. Is there anyway to fix both my nipples permanently?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question and photos regarding gynecomastia and gynecomastia surgery results.  It appears from your pictures that too much tissue was resected underneath the right nipple. This led to a sunken nipple or “crater” underneath the right nipple areolar complex.  This is a difficult problem to treat. However, treatment for a sunken nipple areolar complex is not impossible. I would suggest autologous fat grafting. Autologous fat grafting is a procedure where excess fat is taken from one area of the body and placed in another area requiring tissue.  In your case, I believe fat can be “harvested” from the abdomen, purified, and then transferred to the right nipple “crater”.  By using the autologous fat grafting technique, areas that require tissue can be augmented. Autologous fat grafting can be performed under local, IV sedation, or general anesthesia. In your case, I believe this is the best form of treatment for the right nipple “crater” after your gynecomastia procedure. 
Thank you for your questions regarding gynecomastia surgery. If you have any further questions regarding correction after gynecomastia surgery, please contact my office. Sincerely, Dr. Katzen.

Jed H. Horowitz, MD, FACS · Answer

Your incisions will go through a maturation #process after gynecomastia surgery. For the first few months they will be red and possibly raised and/or firm. As the scar matures, after 6-12 months, it becomes soft, pale, flat, and much less noticeable. You may experience numbness, tingling, burning, “crawling”, or other peculiar sensations around the surgical area. This is a result of the #healing of tiny fibers which are trapped in the incision site. These symptoms will disappear. Some people are prone to keloids, which is an abnormal scar that becomes prominent. If you or a blood relative has a tendency to keloid formation, please inform the doctor. Also, as you heal, the area may feel “lumpy” and irregular. This, too, decreases with time, and massaging these areas will help soften the scar tissue. 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 the indentations can be addressed with cosmetic filler(s) if eligible.

Ira H. Rex III, MD · Answer

It seems like the deformity in your photographs would be best corrected with the release of the scar tissue and fat grafting to give it bulk underneath.

Kenneth Hughes, MD · Answer

The crater can be improved by releasing the scar tissue and fat grafting underneath it.Kenneth Hughes, MDBeverly Hills, CA

Orna Fisher, MD · Answer

There are definitely a few different strategies that can help with your indented nipple areolar area.  The most common would be fat transfer, done by removing fat from another area using liposuction and injecting it into the area that requires volume. You may require more than one treatment. There are also other possibilities using  different biological materials, and cost will vary depending on the procedure that is chosen. To find out what would be the best strategy for you, you would need to be examined in person.

Mordcai Blau, MD · Answer

How should I choose a surgeon?
Selecting a surgeon is as important a choice as the decision to undergo surgery. Choose carefully only a board certified PLASTIC SURGEON. The decision is yours. What follows is some advice to assist in making your selection.
1. Experience matters. Choosing a surgeon who has performed over one thousand gynecomastia cases increases the likelihood that they have seen a case similar to yours in the past. Selecting a surgeon whose practice is focused on gynecomastia exclusively is also an indicator of experience.
2. Results matter. The more before-and-after pictures a surgeon displays, the better. Pay attention not just to the number of pictures, but whether the surgeon is confident enough to show multiple angles of the same patient.
3. Gynecomastia surgery Reviews matter. Have patients reviewed your surgeon? Did those patients undergo the surgery you are considering?
4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Are they certified by the American Board of Plastic Surgery? Have they authored books or medical journal articles regarding your surgery?

We hope these guidelines are of assistance when you are selecting your surgeon. When undergoing surgery, it is very important to be realistic about your expectations. Past results are not a guarantee of future results. Also, revision surgery tends to be significantly more difficult than initial surgery.

Steven Wallach, MD · Answer

Fat grafting may help the depressed one but it may require several treatments. The puffy one might need further resection. Best to be seen in person.

Melissa Johnson, MD · Answer

There are options to correct or improve on this situation.  Loss of volume behind the nipple can be restored with fat grafting.  You also look like you have some excess skin.  Removal of excess skin will improve the contour but may leave visible scars.I recommend getting a second opinion by a board certified plastic surgeon in your area that ideally does a lot of gynecomastia operations and is comfortable with fat grafting techniques.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and the photos and your problem can be corrected and there are several solutions which would require an examination to determine which might be best for you.  So see some experts in your area for a second opinion.  I have fixed similar complications in patients of others so I know it can be fixed.Dr. Corbin

Nipple crater after gynecomastia surgery. Is there a way to fix it permanently? (Photo)

Answers (9)

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