Botched/Ineffective surgery. Should I wait? Or Do it Again? PLEASE PLEASE HELP

[SJV9009]

Hello everyone.  I had gynecomastia surgery in late may to correct a problem i've had since I was 13. I'm a slim 22 y/o guy with not a lot of definition, but not fat by any means. The problem was a hard fatty almost ball-like mass underneath my nipple. I had smart lipo done with very temporary results. The area was flat for only a couple weeks after surgery. Here I am 6 months later and the area looks the same as it did pre-op, only now the area is more sore to the touch. I also was hoping to get the nipple area reduced. What has been the experience with this procedure? Should I simply wait a few more months or go ahead with glandular removal. Again, the surgery was in May and at this point I don't see clear signs of improvement. Thanks so much

[Dr. Elliot Jacobs]

Surgeons use six months as a general guideline for results after surgery.  If things feel bad or look unsatisfactory, certainly it is grounds for you to return to your surgeon and discuss the issue.  Revision surgery may be indicated or perhaps, simply a Kenalog injection might help.  But your original surgeon is the best place to start.

Dr Jacobs

[DrBermant]

Hello everyone.  I had gynecomastia surgery in late may to correct a problem i've had since I was 13. I'm a slim 22 y/o guy with not a lot of definition, but not fat by any means. The problem was a hard fatty almost ball-like mass underneath my nipple. I had smart lipo done with very temporary results. The area was flat for only a couple weeks after surgery. Here I am 6 months later and the area looks the same as it did pre-op, only now the area is more sore to the touch. I also was hoping to get the nipple area reduced. What has been the experience with this procedure? Should I simply wait a few more months or go ahead with glandular removal. Again, the surgery was in May and at this point I don't see clear signs of improvement. Thanks so much

6 months should show the results with most techniques, but tissues can still evolve.  This is especially true with operations that cause more damage to the tissue.

Posting Standard After Gynecomastia Pictures can help other better understand your concerns. Adding the before surgery pictures will help show what was done.

It depends on what you mean by "getting the nipple area reduced."  If you mean Long Nipple Reduction, that can be done as a second stage procedure under local anesthesia.

If you are referring to large diameter areola, you will need to learn about the compromises necessary to deal with that situation. You do not want to end up with a Large Nipple Areola Complication After Gynecomastia Surgery.

If you are referring to a projection deformity, I see many patients who complain of residual Puffy Nipple Gynecomastia after another doctor's surgery.  There are many possible problems causing such a deformity.  The most common is remaining gland behind the areola as seen in these Anatomy of Puffy Nipple Drawings.  Check out the images with the link for remaining gland after surgery to see what I mean. 

Liposuction is great for fat, but does not do well for gland at all.  As shown in the anatomy link, there are usually fingers of gland between fingers of fat.  Liposuction no matter what technique (sharp cutting cannula, specially designed cannula, ultrasonic, laser, or "smart") targets the fat first.  Remove the fat and the gland remains behind condensing the fingers making a firm mass. 
Even if the doctor achieves a flatter chest, that firm mass does not look like fat, move like fat, or compress like fat.  It just does not move well or look good (especially on animation).  That is why few doctors will show results with chest muscles tightened or arms up over the head or movies showing the tissues in motion.

Hope this helps,

Michael Bermant, MD
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