Fat Flaps vs. Fat Injected for Chest Sculpture

[DrBermant]

A number of the gynecomastia.org members seem to have been postiing that I fix crater deformities by injecting fat.  I felt it was an important enough topic to repost the answer here.

Wow! Fat injection! I wish all of my body fat was injected into a big beach ball of fat thru a 6 inch long wire of skin that I could chop with scissors and never have to bother with cortislim!!

Concave? Never seen that before, but take Dr Bermant's advice and have somebody inject some butter into your chest.

Each doctor has tools they prefer for body sculpture to get the results they are able to show.

I do not inject fat into the chest for deformities.  Fat injections means that the fat cells do not have a blood supply and must regain a blood supply.  Tissue transfers without  blood supplies are called grafts.

Fat Grafts into fat tend to die, become firm, and scar badly.  Fat cells grafted into more vascular tissue like muscle can look very strange especially on animation.  The major problem with fat grafting is that it does not work very well and typically looks terrible, especially on animation or movement.

That is why I prefer my Fat Flaps for bringing fat into a crater.  A flap is tissue moved with a blood supply.  Adjacent fat transfered with a blood supply tends to survive, much better than a graft.  When carefully done, fat flaps tend to look like normal fat, feel like normal fat, and move like normal fat.  There are limitations to what fat flaps offer since fat still connected to its blood vessels will move only so far.

I do not use Fat Flap Sculpture on every gynecomastia patient.  For most operations it is much more than what is necessary for good contouring.  Fat Flaps for me are just another tool in my artistic pallet that helps me sculpt the male chest during my Dynamic Technique, where I let what I find during surgery help guide what needs to be done for that individual patient.  What elements I pick from this collection can vary from patient to patient, and sometimes even from side to side.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[DrBermant]

What would you say was the problem here after surgery I had with Mr Levick and how could I possibly remedy it? More lipo to even out the lower parts of the breast that doesn't seem to have been caught well enough?

www.photos.yahoo.com/x1patient

Nasty crater deformities are not remedied by removing more fat and digging a deeper hole.  When the skin sticks to the deeper structures, the deformities look even worse during animation such as tightening the muscles, lifting arms over head, and general movements.  For some problems, Revision Gynecomastia Surgery can help.  Options depend on many factors.  When there is localized fat nearby, extended fat flap sculpture can fill in the defect.  Working with such problems is compromise surgery.  Preventing the problem is much better than trying to fix it with further surgery.  We help patients from around the world explore their concerns and options with either in office evaluations or Preliminary Remote Discussions.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture