Chest looks more or less the same 1 year post-op, please help? (Photo)

It is very hard to make a good judgement based on your photo being very far away. It is possible some of the glandular bud may still be left over. You may just need a little bit more liposuction done in the area around where the bud would be . You should meet in person for a consultation so that an experienced physician can analyze you up close.

Based on the poorly posted side view photo at a distance, which is very difficult to see I recommend reposting better photos or a virtual consultation. Revision gynecomastia surgery fees range from $10,000-$20,000. Best of virtual consult with.

First of all to make a quality assessment regarding the outcome of any plastic surgery procedure we need to see a complete set of proper before and after pictures.
If you don’t have before, and after pictures and asked your surgeon to forward the pictures they took.
To make an assessment regarding gynecomastia, including a postoperative assessment It’s important to recognize. There are tissue variables that fullness in the male chest.
These are excess subcutaneous, fat, excess glandular breast, tissue and skin laxity or loss of skin elasticity.
One of these variables can contribute and potential improvement from surgery depends on understanding each variable, and which variable is treated and if so, how well.
Most successful gynecomastia surgery is done with a combination of liposuction and open glandular excision.
The most complex variable to understand and assess his skin.
Often when results are less than what both patient or surgeon had hoped for there may be a skin laxity condition that was not recognized.
The two variables that are going affect skin are going to be age and history of weight fluctuations.
The best way to differentiate is to put the skin under tension by putting your arm up over your head like you’re scratching the back of your neck. With the skin and pectoralis muscle under tension, we can usually clearly see the thickness of subcutaneous fat and glandular tissue.
You can also carefully change in your chest contour as you bring your arm down and this is how much skin is contributing to the chest shape.
Even mild skin laxity or loss of skin elasticity can have a pretty big impact and diminish gynecomastia surgery outcomes.
This kind of surgery is tricky and not at all straightforward.
It’s very important to have a clear understanding of each three variables and how much each one is contributing.
Whenever I consult with guys who have any history of weight fluctuations or are over the age of 35 I always tell him that the result is probably not going to be as great as they had hoped for.
Excessive glandular Excision can potentially lead to permanent indentation which can be highly undesirable.
Over resecting glandular tissue can be catastrophic and under resecting leads to dissatisfaction because of a lack of results.
It’s not easy and surgeons should generally stay on the side of being safe.
The number of plastic surgeons who approach mastery of this kind of work is also quite small.
This kind of work is in fairly complex and difficult to master.
Took it a proper second opinion scheduled as in person consultations with other plastic surgeons.
For second opinion consultations come prepared to bring with you a complete set of proper before and after pictures and copies of your previous operative report.
A lack of sufficient results from gynecomastia surgery is really common.
Sometimes revision surgery can have a substantial impact. Sometimes it has little impact, and sometimes it can make things worse.
Best,
Mats Hagstrom MD