Crater deformity affecting me and my fiance

[pheeyok]

I'm a 31 year old male that has suffered from gynecomastia.  I had two surgeris with the first one roughly seven years ago.  I seemed to have a crater defect, the doctor told me to work out and build the muscle.  I had previously been working out like crazy, hoping the it would cure my issue.  I had a second lipo done to my chest, with the same outcome.  While I now feel more comfortable wearing shirts, I feel even more self-concious of my crater deformity.  I don't take my shirt off in public due to double the embarassment of: 1)Explaining I had manboobs 2)Explaining I had man boobs and now I have a cratered chest due to a surgery.

I had the sugery around the age of 24-25, and I was bench pressing 270lbs (not max).  Obviously I was doing something right as I continued to get stronger, but I could still never get rid of the crater deformity.

After years of depression, and slacking off at the gym, I've gained weight, but my chest looks no different than before.

I've avoided beaches, pools, and any summer activities for over 15 years.  I'm getting married soon and would love to take my future wife somewhere tropical.  She has also been affected by avoiding the beach due to my self-conciousness.  While she has been fully supportive of me, I still feel bad by making her suffer.

Thanks...

[Dr. Elliot Jacobs]

Once a crater deformity is present, no amount of exercise will improve it -- it needs revision surgery.

Would suggest you consult with an expert who specializes in gyne surgery (there are several around the country) for an evaluation as to what could be done with your situation.  Sometimes major improvement can be obtained -- and unfortunately, sometimes there is nothing more that can be done -- but it is worth a shot. 

I have a mantra which I always talk about with my staff:  if it doesn't look good on the operating table at the end of surgery, it will not magically improve during the healing phase.

In essence, as advice to those contemplating gyne surgery:  choose your surgeon carefully -- the best chance for a terrific result is your first operation.

Dr Jacobs

[DrBermant]

I'm a 31 year old male that has suffered from gynecomastia.  I had two surgeris with the first one roughly seven years ago.  I seemed to have a crater defect, the doctor told me to work out and build the muscle.  I had previously been working out like crazy, hoping the it would cure my issue.  I had a second lipo done to my chest, with the same outcome.  While I now feel more comfortable wearing shirts, I feel even more self-concious of my crater deformity.  I don't take my shirt off in public due to double the embarassment of: 1)Explaining I had manboobs 2)Explaining I had man boobs and now I have a cratered chest due to a surgery.

I had the sugery around the age of 24-25, and I was bench pressing 270lbs (not max).  Obviously I was doing something right as I continued to get stronger, but I could still never get rid of the crater deformity.

After years of depression, and slacking off at the gym, I've gained weight, but my chest looks no different than before.

I've avoided beaches, pools, and any summer activities for over 15 years.  I'm getting married soon and would love to take my future wife somewhere tropical.  She has also been affected by avoiding the beach due to my self-conciousness.  While she has been fully supportive of me, I still feel bad by making her suffer.

Thanks...

A Crater Deformity Defect is a term I coined after seeing some hideous deformities on patients coming to me for help after surgery done elsewhere. I published a collection of patients' pictures defining the problem to try to educate the world for prevention. I also have since published methods to demonstrate the degree of the problem and just how successful corrective surgery can be when there are tissue resources available.

This is a problem that becomes much more apparent when using the chest muscles. When the deepest part of the crater is stuck to the chest muscle skin, flexing, and raising arms up overhead both make the deformity look worse. In evaluating the effectiveness of any treatment, look for such documentation. If the surgeon claims he / she has a fix, look for at least the flexing still pictures. Videos are even more critical. If the solution looks good on video, then it can be something that also looks good living life. I just recently published a unique case where a crater defect was transformed from something that had a fix for it to something even worse, an extended crater. Watching the videos of that "revision surgery" result really is a tell on that doctor's methods. You cannot fix a crater defect by removing the nearby fat making the surrounding areas skin adherent to the chest wall like the central crater.

Here are 2 of the still pictures posted here, but you really need to see the entire set and the video to appreciate the nature of this animation defect:

https://www.gynecomastia.org/smf/index.php?topic=23003.msg153027;topicseen#msg153027

Weight loss can lower the outer edge fat wall of a crater, but does not look good on animation. The sticking skin does not look good. I have seen patients who putting weight on, made the crater deeper. The remaining fat cells put on the weight, but there is nothing to put on if the cells have been removed and the skin is sticking to the muscle fascia. I have not seen any benefit with bodybuilding and crater deformities.

When surgery is not an option, I have been able to demonstrate how my bodyshaping garments can be an option on land. My surfers taught me that the water equivalent is the wet suit. But the beach is a special problem, neither work well. For the beach, the sun protection loose clothing has been an option. These alternatives became an important issue since not all patients are candidates for the revision or they needed to heal until I could offer revision surgery.

Prevention is so much better than having to fix a mess like that. But in evaluating a surgeon's skills for this fix, look for videos demonstrating what they are offering and if not that, at least pictures how flexing and raising arms look. For that matter, if you come up with an alternate method to fix this problem, documenting the before and afters would be a starting point for others to explore such avenues.

Hope this helps,

Michael Bermant, M.D.