What Procedure Would You Follow to Correct my Post Op Gynecomastia Crater Deformity (Pics Included)

My doctor did was I feared he was going to do, which was remove too much (or ALL) of the gynecomastia. I had Bilateral gynecomastia surgery that left me with a crater. Also did horizontal cuts :( Right pectoralis = small gland removed.(looks ok) Left pectoralis = Larger gland removed+larger surgical cut used. (left side is my problem area) Pic #1= Mildly flexing immediately after site was drained. Pic #2= relaxed, the following morning. What procedure will fix this?Currently 4 weeks post op.

Doctor Answers 10

Fat Flap

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The fat flap may work very well in your case.  The surgery closes the crater by bringing the fat together or rotating a flap into position.  I would wait for awhile and let the swelling reduce.

Crater Deformity Concern Following Gynecomastia Surgery

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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. 

Post Op Gynecomastia Crater Deformity

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Hi Onesight1,

Thanks for the post and photos. Over-resection is a more difficult thing to fix than under resection. The most common procedure to fix this is fat grafting to the area. In this procedure liposuction is performed and the fat is then placed in the area that is deficient. There is a chance that one would need to undergo more than one of these procedures based on the degree of cratering, how much fat they have to harvest, and how much or little of the fat gets resorbed. I would wait until 6 months post op because at 4 weeks there is too much inflammation still occurring during the healing phase which could increase the chance that the fat will not take.


Dr. Dadvand

What Procedure Would You Follow to Correct my Post Op Gynecomastia Crater Deformity (Pics Included)

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Give it 6-8 months before assessing the final outcome of the surgery.  You may require fat grafting to correct any contour irregularities.  Good luck and be safe.

John T. Nguyen, MD, FACS, FICS
Double Board Certified Plastic Surgeon

Fat Graft after Gynecomastia Surgery

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Most man are just happy removing the extra breast tissue in their chests but sometimes, over-resection is possible. You should consider fat-grafting to fix the problem. Fat grafting is just liposuction followed by placement of the fat into the defect.

Over resection of gynecomastia

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It looks like you had over resection of the central gland and not any contouring of the surrounding breast tissue. You need to wait at least 4-6 months for revision. t that time you should make sure you have an experienced Plastic surgeon who performs gynecomastia regularly do your surgery. You might get by with further contouring liposuction and ultrasonic liposuction but might need some fat grafting as well.

Gynecomastia contour deformity

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Sometimes patients develop a contour deformity like a donut after over resection which can happen very easily. You should probably wiat a few months for the swelling to subside. You may need to consider strattice or fat grafting to improve the contour.

Fat Injections for Gynecomastia Revision

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Unfortunately, this is a classic example of what not to do in gynecomastia surgery...over resection. This is a much more difficult problem to solve than the opposite undesireable of under resection. This will require fat replacement either through fat injection or a dermal-fat graft. Given the size of the defect, fat injections will be more practical. The question is when to treat being just four weeks after surgery. The demarcation of the defect is fairly clear on flexing and even identifiable when relaxed. I see no benefit to waiting until the skin scars down more firmly to the pectoralis fascia. My approach would be to proceed with revisional surgery as early as six weeks after your original procedure. 

Fixing a contour defect after gynecomastia surgery

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I would suggest you go to a board certified plastic surgeon to evaluate this.  I suspect a non-plastic surgeon did your surgery.  Swelling of the surrounding tissues will continue for a while, so it is too early to speculate what, if anything, you might need to correct the contour.  A divot can often be filled effectively with fat injections.  Unlike a scar within your areola, a scar on the breast skin will be more noticible, and there is nothing that will eliminate it.


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Do not believe the surgeon was a board certified plastic surgeon (American Board of Plastic Surgery)

You need liposuction and fat transfer to the over resected breast, release of the scarred , stuck area to the pectoralis muscle.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.