Horizontal Scars from Gyno Surgery *Updated W/Pics

[Florida Guy]

About 7 months ago, I had my 2nd Gyno surgery and I will be having yet another surgery to remove more tissue in a few months (one side is larger than the other). Anyway, the surgeon used a horizontal incision on each side of my nipples, which left a very noticeable scar. My question is can these scars be permanently reduced in appearance somehow or am I pretty much stuck with them?        

[DrBermant]

About 7 months ago, I had my 2nd Gyno surgery and I will be having yet another surgery to remove more tissue in a few months (one side is larger than the other). Anyway, the surgeon used a horizontal incision on each side of my nipples, which left a very noticeable scar. My question is can these scars be permanently reduced in appearance somehow or am I pretty much stuck with them?         

Scars cannot be erased, just revised. When a scar is placed poorly near the areola, I can often hide it during a Revision Gynecomastia Surgery by moving my new scar to the color interface of the areola and chest. When the prior surgeon extended the scar beyond that nice location, the scar can be revised but not hidden. Here is an example with both, a bad scar above the areola and then it extended beyond to the lateral chest Revision Gynecomastia Surgery for undiagnosed Congenital Adrenal Hyperplasia after regrowth because the first surgeon never bothered to uncover the underlying problem.

Revision gynecomastia surgery is an art form. Not all surgeons have the same skills. I have seen patients go through multiple operations by less skilled doctors digging deeper and deeper holes with problems that eventually have no reasonable solutions. That is why it is essential to carefully pick your gynecomastia surgeon who has demonstrated his / her skills with this sculpture.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[Dr. Elliot Jacobs]

Once a scar is in place, unfortunately it is there forever.  The only thing a surgeon can do is to improve a scar that is already there -- but he cannot erase it and provide you with virgin skin again.

Most scars in younger men take longer to settle down.  They tend to be redder and for a longer period of time than for older men.  But ultimately (it may take a year or longer), the redness should fade away.  If a scar is thickened, then applying pressure on it with special devices, applying silicone sheets or even steroid injections (kenalog) can help to flatten them down so that they are smooth with the surrounding skin.  If the red color is persistent, then sometimes a laser can help to fade it.

Best to give the scars at least 6 - 12 months after your last surgery before beginning a search for treatment.

One last possibility is to tattoo over and surrounding the scars to disguise them.

Dr Jacobs

[Florida Guy]

I see.
Most likely, I will have the scars covered with a tattoo because I don't feel that appearance reduction surgery for the scars will have much impact.  I've attached a picture to give an idea of the situation I am in right now.  The initial surgery was about 16 years ago and literally a waste of time. This is 7 months post op of my 2nd gyno surgery.  Please comment on what you see because I'm not totally sure I wish to go back to the same suregon.  I would really like for my next operation to be the last because I'm very burned out on dealing with this.  If I decide not to rutun to the same suregeon, does anyone have any suggestions for surgeons in Northeast Florida?
Thank you.

[Florida Guy]

Relaxed from the front.

[DrBermant]

I see.
Most likely, I will have the scars covered with a tattoo because I don't feel that appearance reduction surgery for the scars will have much impact.  I've attached a picture to give an idea of the situation I am in right now.  The initial surgery was about 16 years ago and literally a waste of time. This is 7 months post op of my 2nd gyno surgery.  Please comment on what you see because I'm not totally sure I wish to go back to the same suregon.  I would really like for my next operation to be the last because I'm very burned out on dealing with this.  If I decide not to rutun to the same suregeon, does anyone have any suggestions for surgeons in Northeast Florida?
Thank you.

Tattoos will not cover how tissues move. They also will not cover over mismatched edges and contour deformity. Your 2 images are but part of my Standard Photos to Evaluate Revision Gynecomastia Surgery. But even with the single view, there are adhesions and Crater Deformity Defects associated with this problem. Craters are normally under the areola, but I have seen disasters extending well beyond. Missing tissue even at rest just looks bad. Standard Movies Even Better Demonstrate Animation Defects After Gynecomastia Surgery

Remaining fat can be used to reconstruct many defects, when there is enough. For my revision of missing tissue defects, I prefer my Fat Flap Techniques in which I move near fat, preserving the blood supply into the void.

As subsequent attempts to address this defect deplete resources, some patients do not have good options. That is why there should be a careful selection for revision gynecomastia surgeons. Check to see what actual examples that doctor has before and after surgery. Be careful and look for how the tissues move with that technique. Also check how the tissues look and move from various angles. Be wary of someone who claims their method works but they have no pictures or movies to demonstrate the effectiveness of that method.

I see many Gynecomastia Patients from Florida and around the world who prefer my techniques.

I have posted here on How to Pick a Gynecomastia Surgeon:

http://www.gynecomastia.org/smf/index.php?topic=16474.0

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[Dr. Elliot Jacobs]

You have a deficiency of tissues beneath the surrounding skin and probably some adherence of the nipples and scars down to the deeper tissues.  A revision could probably be of help but it would depend upon what local tissue is available to move into the defects.  Scar revision on the surface would also improve the scars so that that the sides are flat and equal.  Tattooing will not help this situation at all.

A skilled plastic surgeon should be able to improve the situation -- but only after a hands-on physical exam to assess everything.

Would suggest you contact Dr. Pope in Orlando, Florida who is a contributing surgeon on this site and a fine surgeon.  His tel is 407  857 6261.

Dr Jacobs

[Florida Guy]

Thanks for the advice.
To clarify, the tattoo option would only be used to help cover the scars providing they could not be reduced to a more normal appearance.  That's what I'm thinking anyway....
Here are a few more pictures to get a better idea of my issues....sorry for the poor quality.

[Florida Guy]

Would suggest you contact Dr. Pope in Orlando, Florida who is a contributing surgeon on this site and a fine surgeon.  His tel is 407  857 6261.

I have sent him a message.
Thank you very much.

[Florida Guy]

Update.
Aetna will not cover my visit (etc) with Dr. Pope.
This really sucks because I was looking forward to getting this taken care of by someone who really knows what they are doing.

Any other suggestions for a Doc in Florida?