Do you recommend liposhifting?

Question

I had gynecomastia surgery one year ago. Nipples are still puffy. My doctor said there is a bit of scar tissue and fat tissue. Definitely no gland but he said another surgery will result in more scars but my question is do you recommend in this case lipo shifting to contour the chest and help flatten it? my chest is 89 cm exhaled and 94 inhaled. height 183 cm

Christine A. Hamori, MD · Answer

If you have persistent breast tissue beneath your areola it is most likely glandular breast tissue. Scarring from gynecomastia usually indents the nipple and areola rather than making them protrude more. It would be best to discuss surgical excision of the breast tissue beneath the areola with your plastic surgeon. The scar is usually very fine and placed between the pigmented skin of the areola and the breast skin on the bottom half of the areola. Liposuction usually cannot remove breast tissue because it is too dense.

Jason Emer, MD · Answer

I suggest removal of the scar tissue and HI DEF VASER contouring of the chest with fat transfer to get the most athletic shape.  Please post photos.  Best, Dr. Emer.

Curtis Perry, MD · Answer

Without seeing the results I can't recommend a revision or not. Do you remember that it is not normal to be completely flat. Persisting excessive fullness under the nipple area usually indicates that there is still some gland and perhaps fibrous tissue left in which case a revision procedure would be indicated.

Jonathan Weiler, MD · Answer

From the sounds of it you need a revision , especially if your nipples are still puffy ... seek a experienced PS to discuss your options , good luck !

Mark T. Boschert, MD · Answer

So if I understand correctly, you had liposuction? Or excision of gynecomastia tissue a year ago?  If you had Liposuction I would bet that you really needed excision. If you had excision and are still not happy with the results then you probably need more excision.  if you had the scission around the areola the visible scar should be almost none at this point and going back to take more won't cause a bigger problem. I would suggest seeing a board-certified plastic surgeon who has experience with all kinds of gynecomastia. Best of luck!

Mats Hagstrom, MD (license on probation) · Answer

I don't think you're going to get an accurate recommendation without him and examination or at a minimum a picture.
To recommend a procedure requires making an accurate assessment or diagnosis first.
I'll people have glandular tissue and men are no exception.
Most men was going to come ask you have excess of granular tissue to some degree.
In some men it's mostly fat and others it can be a full developed breast.
My practice is devoted exclusively to body contouring use liposuction and fat transfer procedures.
When results are insufficient was just liposuction sometimes I will make a very small incision at the junction of the Ariola and regular skin and remove some of the tissue underneath the nipple.
The incisions generally heal with minimally visible scars.
Lipo shifting  can be an option for patients who have been over liposuctioned.
Consider a second opinion from an experience board-certified plastic surgeon or follow your doctor's recommendations.
Best,
Mats Hagstrom M.D.

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