The Dreaded Crater Deformity

If you’ve done some research on gynecomastia as most of our male breast reduction candidates do, you have probably investigated some of the complications that can occur. One is an outcome that’s somewhat rare but still worrisome for patients: the crater deformity.

A crater deformity looks like you might expect – it’s a depression under the nipple/areola complex. Naturally, a patient who seeks surgery for prominent male breasts does not want to end up with the reverse! Crater deformities do not look natural and, unfortunately, can be tricky to fix.

The Best Defense

As in football, where the best offense is a good defense, the ideal way to handle a crater deformity is not to get one in the first place. In working with several thousand patients seeking male breast reduction, we’ve found that a potential crater is usually evident during or near the end of gynecomastia surgery. Should this happen, an experienced gynecomastia surgeon can mobilize nearby fat flaps and suture them together underneath the skin. During the operation, tissues are loose and can be moved for this purpose.

We never complete a procedure if there’s any evidence that a crater may form. Surgery is finished only when there’s a completely firm, smooth contour. That’s why our gynecomastia revision surgery rate is nearly zero.

If You Have a Crater Deformity

We do perform quite a number of revision surgeries for patients who have had their man boob surgery with another doctor. Each case is unique, both inside and out, so our approach is to customize the revision. We start by carefully evaluating the patient, and we review the first surgeon’s operative report whenever possible.

The procedure itself can include one or more of these options:

– Fat suturing: If there’s sufficient fat tissue surrounding the crater, some may be loosened and stitched together just as in an initial procedure. This technique can be more challenging in a secondary operation due to the formation of scar tissue.

– Fat grafting: When there’s little fat available nearby, or when the depressed area is quite small, fat cells can be harvested from elsewhere, cleansed and injected into the crater. Occasionally this maneuver needs to be performed more than once.

– Liposuction: Once a depressed area is filled in with fat, very precise liposuction of surrounding tissues may help in achieving a smooth appearance.

– Scar tissue: If scar tissue under the skin contributes to an irregular surface, this tissue may be reduced through cortisone injections or careful excision.

Whether you’re planning a primary or secondary gynecomastia surgery, the single most important move you can make is to place yourself in the hands of a male breast reduction specialist. While no surgeon can guarantee a perfect result, there’s no better way to increase the odds of a great outcome for you than by consulting an expert.

We invite you to learn more about our practice, view our before and after gynecomastia photos and contact us for a consultation.