Areolas folded 4 years after gynecomastia surgery. Possible to revise? (Photos)

Hello,The sharp, sunken creases along the areolas can be a results of aggressive tissue removal, scar retraction, or native nipple inversion(least likely).  In any case, these depressions can be improved with in office filler injections or with fat grafting.  A series of these treatments may be needed to achieve the desired results.Warm regards,Dr. Pedy Ganchi                                                                                                                                         Village Plastic Surgery

Dear Sad_Tittyman,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would get some improvement with fat transfer. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Yes, it is possible to revise the appearance of the areolas if they have become folded or otherwise distorted after gynecomastia surgery. Revision surgery is a common option for addressing issues such as asymmetry, irregularities, or dissatisfaction with the results of the initial surgery.Here are some common techniques that may be used during a revision surgery to correct folded or distorted areolas:1. Areola resizing: If the areolas have stretched or become misshapen, the plastic surgeon may resize them to achieve a more symmetrical and proportionate appearance.2. Areola repositioning: If the areolas are not centered or have shifted position, the plastic surgeon may reposition them to a more aesthetically pleasing location on the chest.3. Scar revision: If scarring around the areolas is contributing to the folding or distortion, scar revision techniques may be used to improve the appearance of the scars and surrounding tissue.4. Tissue rearrangement: In some cases, the plastic surgeon may need to rearrange or redistribute the surrounding tissue to achieve a smoother contour and prevent further folding or distortion of the areolas.It's important to consult with a skilled plastic surgeon who has experience in revision gynecomastia surgery to discuss your concerns and goals. During the consultation, the plastic surgeon will evaluate your individual case and recommend the most appropriate course of action to achieve the desired results. They will also discuss the potential risks and benefits of the procedure, as well as the expected recovery process.

Excising all breast tissue under the nipple will often result in a depression. It the depression can be grabbed and pulled upward indicating it's not tethered to scar tissue. If so fat injection or filler can be injected to fill the depression. If the depression is fixed then using the existing incision to release the scar will then allow fat injection to work better. 

Thanks so much for your question!  There are a few different ways to approach this problem, depending on your priorities.  The simplest way would be to excise a crescent of areola in order to stretch out the nipple more.  This may be able to be performed in the office.  Another way to address the area would be to inject a small amount of fat into the area underneath your areola, in order to correct for a possible excess amount of resection (or fatty tissue removal) in the first procedure.  
Good luck and stay safe!  Dr. Schneider

This problem can occur to anyone. there was an aggressive removal of breast tissue beneath the areolae or perhaps the act of undermining them. Regardless it is has left you with indented scars on both sides. I would recommend under local anesthetic in your plastic surgeon's office, freeing up the scar tissue and transferring a small amount of fat to this area. This has an excellent chance of significantly improving things for you. you should be able to return to work the next day.david berman md