Can my scarring and ridging after gynecomastia surgery be corrected? (photo)

To make a quality assessment regarding the outcome of any plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If you don’t have before, and after pictures, then ask your provider to forward the pictures they took.
Without knowing what you look like before the procedure, we can’t assess the outcome accurately.
There are three tissue variables that can contribute to fullness of the male chest.
These are excess subcutaneous, fat, glandular breast, tissue and skin, laxity or loss of skin elasticity.
It looks to me like you had fairly aggressive Liposuction, and some of that was unfortunately done on the upper part of your chest and into your armpit. I generally do not remove it volume from the upper part of the chest because it makes the pectoralis muscle look small.
I generally liposuction aggressively only on the lower part of the chest and try to maintain the appearance of a strong pectoralis muscle by not removing fat at the edges of the muscle except the lower part. It would be helpful to know if you had glandular breast tissue removed with an open excision as well.
I generally like to put the skin and pectoralis muscle under tension when doing an examination.
Doing so allows us to visualize the soft tissue components, very accurately.
You could do this yourself by looking in the mirror while taking one arm at a time And stretching it behind your head like you’re scratching your upper back. Have someone take a picture while doing this and make sure you do it one side at a time so you can have the other side to look at for reference.
With the skin and pectoralis muscle under tension, you’ll have a really good idea of what the subcutaneous fat and any breast tissue actually looks like.
When we put the arm down The skin tends to drop creating some fullness in the lower chest.
Poorly done, Liposuction that leaves an uneven fat distribution is very difficult to correct.
The more aggressive, the primary procedure the more difficult it is to improve on the outcome.
Delivering consistent quality liposuction results is more difficult than most people realize.
The number of plastic surgeons who approach mastery of Liposuction is in reality quite small.
Most plastic surgeons think they’re better at Liposuction than they actually are.
Revision work is many times more difficult than primary procedures.
Recognize that any attempt at revision can make things worse.
This means that before you contemplate having a second procedure, you need to carefully vet providers and make sure you’re in the hands of someone who is really really good at Liposuction.
That may take Quite some effort.
Most plastic surgeons are merely average.
I guess that’s the definition of average.
To find someone who has approached mastery of this kind of work, you’re looking at the 95th or 98 percentile or better.
This means you may have to consult with quite a few providers.
During each consultation, ask each provider to show you as many before, and after pictures of previous gynecomastia work as possible, preferably of people who have very similar body characteristics to your own.
This can be difficult because even slight skin laxity or slight excess glandular tissue can give a very different appearance.
It’s really important to clearly differentiate the three tissue variables that come into play for this Type of work.
You should also ask providers to show you examples of revision work, and if they have examples of gynecomastia revision work, you definitely want to see that.
To me the first question is if your gynecomastia condition has been treated adequately or if there’s room for improvement in that area.
Is your concern simply the uneven contour from the previous liposuction?
Creating an even contour from poorly done, Liposuction, especially when it was done aggressively is going to be really difficult and may not be possible.A partial improvement may be all that’s possible and whether that justifies having surgery or not is not an easy question to answer.
By far the most important variable is provider selection so if your motivated enough to consider having a partial improvement and you recognize that revision work can potentially make things worse than start the process of finding the right provider.
And the hands of the right provider the chance of having things turn out worse is unlikely.
The chance of only having a minor improvement is very real and fairly likely.
Good luck,
Mats Hagstrom MD