Gynecomastia Revision and Your Expectations
We may see more men for revision gynecomastia surgery in NYC than almost any other plastic surgeon in the country. Our practice has built a body of expertise in male breast reduction and a track record of results that give us a good reputation for success. While some men are content to try less experienced surgeons for some reason (often proximity) for an initial procedure, they often to turn to us when the first surgery yields a disappointing outcome.
One of the most important concepts we discuss with our revision patients is “expectations.” In our consultations, we spend plenty of time talking about achieving “improvement” rather than “perfection.” If we recommend a revision procedure, we are always confident that we can create vastly improved contours. But a “perfect” chest may not be in the cards for these reasons:
- Scar tissue: Prior to male breast reduction, the chest is composed of breast gland tissue and fat. After surgery, scar tissue is also present. Due to its tough, fibrous nature, scar tissue is more difficult to contour.
- Irregularities requiring the addition of fat: Sometimes a surgeon will remove too much tissue from the chest, resulting in craters beneath the areolas or unnatural valleys under the skin. These can be treated with fat flaps, fat injections or both. Occasionally, some of the added fat may not “take,” indicating a second round may be needed.
- Scars on the surface: Scar formation on the skin can be as unpredictable as it is under the surface. If an incision healed with a prominent scar, we can remove it, reconstruct the area and suture it to encourage better healing. But another scar will be the inevitable result – there’s no way to avoid this.
- Skin/nipples out of position: If the first surgery resulted in saggy skin and/or nipples positioned too low, we will often recommend a removal and repositioning procedure. We can create a much more youthful looking chest with tighter skin, but there will be additional, permanent scars.
With any surgery, there are tradeoffs to be considered. When a patient is thinking about a revision procedure, surgery itself is likely to be more challenging than the first time around. The results will range from moderate to dramatic improvement, but they may not be what the patient could have achieved had the initial surgery been more successful.
We welcome men considering revision gynecomastia surgery to our NYC office. We have many tools from instruments to experience to help create improvement through a breast reduction do-over. And on the rare occasions when we feel it’s best to leave well enough alone, we will always be honest about it.