can i have fat injected back into my chest to fill the indentation???

[crazygyne]

I had surgery with Karidis in Aug 08 & I'm very happy with the results compared to how they used 2 be but the only problem i have is there is a noticeable indentation when i raise my arms above my head, i know other people have mentioned this and was wondering if a fat injection is a possibility? If so how many others with the same problem would go ahead with it  

[enuff]

Do you walk around with your arms above your head alot then? 

[as400]

Apart from that though now your 6 months down the road how have things settled down?

[kingboob]

I believe fat injection can be done, but from what I have read it is quite difficult to get right because some of the fat gets re-absorbed and the results do not always work out as expected.

You really need to speak your doctor/surgeon about that.



Personally I wouldn't bother if your chest looks good in a normal position...... I mean how often are you going to go on a beach with your arms above your head?  And even then how many people would notice a small crater?

[crazygyne]

Kingboob thanks for the info, i understand what your saying & overall it doesn't really bother me, i was just curious. thanks for your contribution to this board, before getting surgery myself reading comments from people like you really helped me to get it done, So once again thanks for all your input.

[Albion71]

Hi Crazygyne.

Yes, a fat injection is a possibility, and that's what I'm planning to have on my left side, where I have an indent.

Karidis didn't really do a very good job with me (check my diary and pics), and has agreed to do revision surgery.

I am a bit worried about it though, as he will have to inject considerably more fat than the area he wants to fill - this is due to absorption. God knows what it will look like at first. Also, I think part of the reason for the indentation is that he's taken out too much tissue rather than fat, so whether this is the answer to the indentation I'm not sure.

[hadenuf]

Hi Crazygyne.

Yes, a fat injection is a possibility, and that's what I'm planning to have on my left side, where I have an indent.

Karidis didn't really do a very good job with me (check my diary and pics), and has agreed to do revision surgery.

I am a bit worried about it though, as he will have to inject considerably more fat than the area he wants to fill - this is due to absorption. God knows what it will look like at first. Also, I think part of the reason for the indentation is that he's taken out too much tissue rather than fat, so whether this is the answer to the indentation I'm not sure.

Hi mate. I had mine done last october and overall I look well but like you it is not as expected. My right side is very good with a nice contour but my left is much flatter and sort of looks like the top of a mountain has been chopped off but not as drastic as that if you know what i mean. Anyhow my left seems like too much has been taken and also I still get the bad creasing across both nipples when ever my chest is slightly tensed, ie when I wash my hads etc. It still does not look natural totally but I know there is still some time until the 12 months mark and he did not seem concerned about anything when I saw him in December.

Am I worrying unduly at this stage in the healing process?

[DrBermant]

I had surgery with Karidis in Aug 08 & I'm very happy with the results compared to how they used 2 be but the only problem i have is there is a noticeable indentation when i raise my arms above my head, i know other people have mentioned this and was wondering if a fat injection is a possibility? If so how many others with the same problem would go ahead with it  

Options for revision of Crater Deformity Scars after Gynecomastia Surgery depend on the original problem, what was done, what resources are left, after care, scar care, how the patient healed, and many other factors best explored during an evaluation.  I prefer to leave a natural layer of fat between the skin and the muscle that preserves natural motion of tissues.  When the layers scar together and there are adequate resources to revise the scars, then revision surgery may be an option.  I have revised many such deformities from other doctor's operations. Unfortunately I also have seen so many other patients where there is just nothing left to rebuild with.  A Fat Flap Gynecomastia Sculpture takes nearby fat, trying to maintain its blood supply, and filling the defect with living fat.   Fat taken from other parts of the boy without a blood supply are grafts.  A good deal of such transferred fat dies and usually becomes firm.  This firm tissue can be just as firm as other scars or gland and does not look good especially on animation.  The fat flap moves like normal fat.

Firm fat, dermal fillers, and molded implants all can have values for scars, but just do not look good on tissues that are supposed to move.

Arms over head pictures show one dynamic component.  Flexing the chest muscles another.  Watching tissues move, as in a volleyball player's exposed chest, is proof of the effectiveness of a technique.  Yes, a good gynecomastia surgery should also look good when the arms are raised over the head. 

Making something look good for a still picture can be a partial achievement.  It reminds me of the story of the fantastic prosthetic ear for the patient missing an ear.  It looks great until it falls off during a dinner party into a soup bowl!  Each option has its limitations.  I have never seen fat grafts used with any technique that look adequate on animation.  That includes work from those teaching such techniques at meetings.  Watching them move in person or movies tells the story to me.  The results of even the field's experts are just not something I like and so do not offer.  Our field of plastic surgery keeps on moving forward with evolution in techniques.  I am looking forward to the day that such techniques really offer a satisfactory solution.

Hope this helps,

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