Sunken look

[Slayers]

What percent of patients have a result of a depressed/sunken chest and or inverted nipple form having the gland removed?
Can this be prevented? Is the cause dependent on the amount of gland that needs to be removed?

[Dr. Elliot Jacobs]

There are no stats as regards crater deformities.

Crater deformities should be rare or non-existent in the hands of an experienced gyne surgeon.  It is the inexperienced surgeon who may not recognize it during surgery.  It has nothing to do with the amount of gland that is removed.  I have at times removed huge amounts of gland, recognized any potential contour problem and taken steps during surgery to correct it so that the result is a smoothly contoured chest.

Dr Jacobs

[Dr. Schuster]

Any type of irregularity is a risk of gynecomastia surgery. This should be very low however. It is hard to get things perfect every time. My own experience proves that correction can be done with a revision rate of 2-3%. I think that the Lateral Pull Through technique helps to reduce the need for revision because it does not violate the areola and reduce the chance of over resection beneath the nipple. This also allows me to be just a bit conservative so that all of my revisions have only needed a little lipo to finish the job.

[Dr. Robert Wilcox]

Dear Slayers,

The patient should not have a depression on the chest from removing the gland unless it has been over-resected and/or the surgeon did not feather out the resections in the periphery of the glandular tissue. It is operator dependent. It is possible with the standard 3 to 9 o'clock incision to have a scar contracture pull down the nipple and invert it. This is a giveaway of having had prior gynecomastia surgery.

Gynecomastia surgery is the most common procedure i do in my practice. 11 years ago i came up with a technique to perform the entire surgery with a incision in the armpit. Since there is no break in the skin around the nipple and the areola, it is extremely unlikely to scar down and distort the nipple.

I hope this has been helpful to you.

Sincerely,

Phone: 972-372-9313
Website:Dr. Wilcox.com'); return false;" class="underlinelink" href="https://www.gynecomastia.org/doctors/robertwilcox/profile">Dr. Wilcox.com" rel="nofollow" onClick="recordOutboundLink(this, 'Outbound Links', 'http://www.Dr. Wilcox.com'); return false;" class="bbc_link" target="_blank" rel="noopener" target="_blank">www.Dr. Wilcox.com

[DrPensler]

There is a spectrum of gynecomastia cases and clearly the more severe the case the higher the likelihood of a problem postoperatively. Patients can have a depression after surgery if there is overesection  of tissue but in some cases poor skin elasticity can be problematic as well. Photos are useful in evaluation.