Revision Gynecomastia Surgery Before & After Patient 19673

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This patient had previous revision gynecomastia surgery elsewhere and complained about continued fullness beneath each nipple-areola complex. On examination I noted some firm tissue present beneath each nipple-areola and we decided it would be best to excise this tissue.You can see the difference in the post-operative photos. It isn’t a “huge” difference that can easily be appreciated in the photos but there is a difference and it’s a big deal to the patient. He is happy with the result. You can see that I ended up removing half dollar sized glandular tissue that sat behind each nipple-areola complex area and caused the “puffy nipples”. Lessons to learn:

Recurrence of gynecomastia is uncommon. The most likely cause of recurrence is incomplete removal of the tissue at the original operation. If you have glandular tissue present (and most men do), and you have had treatment ONLY with liposuction, guess what…the tissue remains and the puffiness continues and you and your doctor become convinced that it recurred (not my fault kind of thing). This is why doctors who try to entice you with liposuction alone treatment for gynecomastia cannot be serious people because they are more concerned about attracting you to something that offers “no scars” when in the vast majority of patients this will not offer the best result. isn’t that what you really want?

You are not “crazy” if you have some residual fullness in the nipple-areola area after treatment in many cases. It’s usually tissue that remains and needs to be removed. There is a balance between removing too much tissue and creating an irregularity and leaving tissue and having fullness or puffy nipples. I pioneered the “turnover” flaps for gynecomastia procedures to replace the glandular tissue that is removed completely with normal fatty tissue. This way we achieve the goal of removing all the gland and having a great contour.

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Revision Gynecomastia Surgery BEFORE & AFTERS | Patient 19673

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