Scaring and collapsing nipple almost 2 years after gynecomastia surgery. What options do I have? (photos)

Question

Hello doctors I hope to hear hopefully some positive news I am approaching 2 years after gynocomestia surgery I will hit 2 years in December 2019. The photos basically speak for themselves I am regretting getting the surgery I have scarring all over my chest and a collapsed nipple is there anything I can do about the scars? I got an acid shot on the nipple and it did not work. Is there any procedure I can do for both the scars and nipple thank you.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  At two years out you have reached your long-term results.  Unfortunately it appears that your body has a tendency towards hypertrophic scar formation, leading to the thickened appearance of all areas from the surgery.  Conservative treatments such as silicone sheets are likely not to be of benefit but you may wish to consider surgical scar revision with early cortisone administration to help prevent a recurrence.  As for your gynecomastia results this would depend on an in-person examination of your tissues to rule out any retained tissue and to determine whether fat grafting to improve tissue collapse may be an option.  Talk to your surgeon for the best advice.

Ashley Thorburn, MD · Answer

If you're experiencing scarring and nipple collapse almost two years after gynecomastia surgery, it's essential to consult with your plastic surgeon or a qualified healthcare professional. They can assess your specific situation, determine the cause of the issues, and recommend appropriate treatment options. Here are some general considerations:1. Follow-up with Your Surgeon:• Schedule a follow-up appointment with your plastic surgeon to discuss the scarring and nipple collapse. They can physically examine the area, assess the extent of the issues, and provide insights into the potential causes.2. Scar Management:• If scarring is a concern, your plastic surgeon may recommend scar management techniques, such as massage, silicone gel, or other topical treatments. In some cases, laser therapy or corticosteroid injections may be considered to address hypertrophic or keloid scars.3. Nipple Reconstruction:• If your nipple is showing signs of collapse or deformity, your plastic surgeon may evaluate the need for nipple reconstruction. This could involve various techniques to reshape the nipple and improve its appearance.4. Revision Surgery:• In some cases, a revision surgery may be considered to address persistent aesthetic concerns or complications from the initial surgery. This may involve further contouring, scar revision, or adjustments to achieve a more satisfactory outcome.It's crucial to communicate openly with your plastic surgeon, discuss your concerns, and work together to develop a treatment plan. Keep in mind that individual responses to surgery and healing can vary, and addressing concerns promptly may contribute to better outcomes. Avoid attempting self-treatment without professional guidance, as it's important to understand the specific nature of the issues you're experiencing.

Matthew A. DelMauro, MD, FACS · Answer

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) Based on your photos, the nipple/areola may not have sufficient support underneath it (due to the tissue resection) compared to the tissue around it or may be tethered to deeper structures due to scarring. (A physical exam is necessary to delineate the cause of your condition.) Liposuction of the surrounding area, fat transfer under the nipple/areola, and/or scar release may be good options to improve this. Scar revision surgery may also be a good option to improve the prominent scars on your chest. You should schedule an appointment with your plastic surgeon so that he/she can address your concerns, examine you, and develop a plan of care. Best of luck!
Matthew A. DelMauro, M.D.

Jeffrey Nelson, MD · Answer

Thanks for your question and photos. There appear to be several small scars on your right breast that are thickened so you may be a hypertrophic scar former. This means you are just more prone to thicker scars than the average bear. Occasionally a formal scar revision can turn out great, but also half the time a bad scar may come back. Some fat grafting might fill out slight contour issues under the areola and nipple, but that area is a bit scared now so it may or may not work. Discuss these options with a surgeon who does a great deal of gynecomastia surgery so you can be sure they have experience with these types of revisions. Even a liposuction access incision may thicken in you so be sure to plan even stab incisions well in case that happens.

Scaring and collapsing nipple almost 2 years after gynecomastia surgery. What options do I have? (photos)

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