Is revision gynecomastia for gland excision more risky than the initial operation?

I am 9 months post op and one nipple is puffy while the other is flat. My doctor said he can fix this under loca anesthesia but my question is it more riskier than the initial operation since now i have already been operated on? So i have a greater likelihood to suffer from nipple or skin necrosis? Dont know if i should do this or just live with the botched surgery

Doctor Answers 7

Risks Associated with Gynecomastia Surgery

The treatment of gynecomastia involves removing the tissue that is causing the chest to look puffy or enlarged. In most cases this involves removing 100% of the breast tissue. However, sometimes a very small amount of tissue may need to be left behind to avoid any contour abnormalities. For this reason, it is always discussed with patients that if they continue steroid use after surgery there is a chance that #gynecomastia may return, albeit to a lesser degree.

As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.There are three types of surgical treatment options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal candidate. Weight, and more specifically body mass index (BMI), need to be considered when deciding. For instance, studies have shown that patients with BMI > 30kg/m sq (placing them in the obese category) have a higher complication rate. Therefore, it is important for patients to be as close as possible to their normal body weight prior to surgery.
 Not only will this decrease risks of complications, but will also enhance the aesthetic results. Further, normal body weight is different from one patient to another.

Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Revision gynecomastia

Dear foreveryoung908,

Thank you for your clinical post. Repeat surgery in an operative field generally comes with a slightly greater risk. There is added scar tissue and the risks are usually associated with achieving optimal contours in the bed that has compromised tissues. There is slightly increased risk for skin necrosis including the nipple areolar complex. However, revision gynecomastia surgery can often be done with energy-assisted liposuction. I have been performing SmartLipo, BodyTite and VaserLipo for over 8 years and find that scar tissue and glandular tissue can be coagulated and liquefied with these techniques, which greatly minimizes the risk of post-operative complications. I would encourage you to follow-up with your operative surgeon and see if they have these techniques in their practice, if not, perhaps seek them out.

BodyTite emits electrical current energy and can coagulate scar tissue and gland as well as lead to good skin contraction with internal-external thermal monitors it’s a very safe and effective way to have no scarring technique of glandular reduction even for secondary surgery.

I hope this information is of some assistance and best of luck.

To find out more, please visit the link below.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.7 out of 5 stars 80 reviews


It depends on your prior surgery and amount of work to be done at this surgery, but generally it sounds like you need a fairly minor revision and should be safely done.

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 16 reviews


It sounds like based upon you description that  your surgery might be fairly simple. Best to review it with you rsurgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Revision Surgery

Without knowing what your previous surgery entailed and being able to examine the area I cannot give you an exact answer. However, revision surgery for excision of excess glandular tissue under the nipple is quite safe and often yields excellent results with minimal risk of complication. Hope that helps, Dr, Kludt

Nathan Kludt, MD
Stockton Plastic Surgeon
5.0 out of 5 stars 24 reviews


Thank you for the question and your concerns but to adequately answer your question an examination is needed.  That said a revision that you describe is generally easier then the first surgery.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 58 reviews

Revisons Are Easier

A localized excision of residual gynecomastia is safe and a lot easier than the  original procedure.  Your doctor considers it a local excision and this is quite safe.  Risk of complications is less than the original procedure.
Good luck.

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.