caved in nipple

[r2theoozbeck]

Hi,
So I had gyno surgery about 6 months ago and now when I raise my arms my right nipple caves in. It also has a scrunched look when I lay down. What can be done to fix this?Attatched are pictures of both nipples arms raised laying down and one with both arms down. 

My left nipple (the normal one) has a firm nub behind it. I had this on my right side but it was taken out. I believe this is why it caves. If fat grafting is done, will the consistency be the same as this firm nub?
Hope to hear soon. Thank you.

[Dr. Elliot Jacobs]

This is the appearance of a crater deformity -- a non uncommon problem after gynecomastia surgery.

If you are six months post op, then you would be ready for revision surgery.  Look for a gyne expert in your area and seek several opinions if possible.

God luck!

Dr Jacobs

[Litlriki]

Agree with Dr. Jacobs.  You don't give any details of your surgery--was only one side operated on?  Often, patients with gynecomastia can feel a firm mass deep to the areola, and most of this is removed along with an appropriate amount of fat (using liposuction) to contour the chest and avoid a crater.  If excision alone is carried out, this puts you at greater risk for a crater deformity in many cases, since the surrounding fat is unchanged.  Fat grafting or use of local fat flaps won't necessarily give you the same feeling afterward, since the tissue may not have the same consistency as the original gynecomastia tissue.  

[r2theoozbeck]

Hi doctor Silverman,

    Both sizes were operated on. and only excision was done. However one side has a firm nub under Nipple, while the other has a small void. The dent appears on only my right one when I lift my arm.
   
     Would a fat flap or fat graft fill provide a natural look similar to the firm nub on my left side?