Gynecomastia revision, 12 years post op - minimally invasive procedure to untether the skin? (photos)

Release of deep adhesions can be done in different ways using an small incision for placement of special fork cannula or a small blade. Fat grafting of the area should follow. However, it is unpredictable whether all of this will address asymmetry of areolas and expand smaller areola sufficiently. Open approach would give a better chance to address that issue? Good luck.

Gynecomastia revision surgery aims to address issues that may arise years after the initial procedure, such as tethered or adhered skin. Minimally invasive procedures for untethering the skin can provide a solution with reduced recovery time and less scarring. Here are some options and considerations for such a procedure 12 years post-op:
1. Scar Tissue Release
• Subcision: A needle or cannula is inserted under the skin to cut the fibrous bands causing tethering, allowing the skin to release and smooth out.
• Radiofrequency-Assisted Lipolysis (RFAL): Techniques like BodyTite use radiofrequency energy to heat the tissue, breaking down scar tissue and promoting skin tightening.
2. Liposuction
• Ultrasound-Assisted Liposuction (UAL): Uses ultrasound energy to break up scar tissue before suctioning out the fat, helping to release the skin.
• Laser-Assisted Liposuction (SmartLipo): A laser fiber melts fat and releases tethered areas while tightening the skin.
3. Fat Grafting
• Autologous Fat Transfer: Fat is harvested from another part of the body and injected into the tethered area to smooth out contour irregularities and provide volume.
4. Minimally Invasive Skin Tightening
• Radiofrequency Microneedling: Combines microneedling with radiofrequency energy to break up scar tissue and stimulate collagen production for smoother skin.
• Thermage or Ultherapy: Non-invasive treatments using radiofrequency or ultrasound energy to tighten the skin and improve elasticity, potentially reducing the appearance of tethering.
5. Consultation and Customization
• Plastic Surgeon Consultation: A consultation with a board-certified plastic surgeon specializing in gynecomastia revision is crucial. The plastic surgeon can assess the extent of tethering, skin quality, and other factors to recommend the most suitable minimally invasive option.
• Customized Treatment Plan: Based on the assessment, a plan can be developed to achieve the best possible outcome with minimal downtime.
6. Post-Procedure Care
• Compression Garments: Wearing compression garments as recommended by the plastic surgeon to help with swelling and support the new contour.
• Follow-Up Visits: Regular follow-up appointments to monitor healing and address any concerns promptly.
These procedures aim to address tethered skin with minimal invasiveness, promoting a smoother and more natural appearance. Consulting with an experienced plastic surgeon will provide the best guidance tailored to individual needs and conditions.

Based on the posted photo a local anesthesia option would be sub and dermal fat grafting down site groin with bolster dressing to fill the indentation of the previous surgery. Expect me to arrange from $3000-$5000. Best of virtual consult with.