Gynecomastia Revision Surgery

Revision gynecomastia surgery or secondary gynecomastia surgery is the name for a procedure that follows surgery for male breast reduction that has not been satisfactory. Revision surgery can provide excellent results for patients with enlarged male breasts who have been let down after initial gynecomastia surgery.

Revision gynecomastia surgery is often more complicated than performing initial gynecomastia surgery. Each case must be carefully assessed, and extreme skill is required to correct deformities or apparent indentations.

Revision gynecomastia surgery usually requires additional tissue removal and sculpting and may need fat flaps or fat grafting. These procedures depend on the skill, expertise, and experience of the plastic surgeon for the most favorable results.

Miguel Delgado, MD, is an exceptionally skilled board-certified plastic surgeon and has performed gynecomastia surgery and revision surgery for over 30 years. Providing individualized gynecomastia surgical options for all types and grades of gynecomastia symptoms, over 40% of Dr. Delgado’s patients come to him for gynecomastia revision surgery.

Gynecomastia studies have estimated gynecomastia revision surgery rates for men who require a second procedure is 17.4%. Men with grade 2 gynecomastia symptoms were found to have the highest rate of unsatisfactory results, with an estimated rate of 34.8% requiring a second surgical procedure. In comparison, Dr. Delgado has a high patient satisfaction rate with a very low 1 to 2 % rate of gynecomastia revision procedures required following an initial gynecomastia surgical procedure.

Gynecomastia Revision Surgery with Dr. Delgado

Dr. Delgado performs surgery at his federal and state-accredited surgical facility, the Gynecomastia Center of Excellence, Marin Cosmetic Surgical Center. Working conscientiously with his team, he is committed to ensuring every surgical procedure has the highest optimal outcome. A member of the American Society of Plastic Surgeons, Miguel Delgado is dedicated to understanding individual patients’ concerns and goals. Performing gynecomastia surgery for approximately 160 men annually, his intention is to continue to develop professional standards in gynecomastia surgery and patient care.

With extensive experience with gynecomastia corrective surgery, Dr. Delgado understands that it is normal to feel apprehensive about undergoing a second gynecomastia surgical procedure. If you want to discuss your options, Dr. Delgado is happy to answer any questions in a free virtual consultation.

Top Three Reasons for Male Breast Revision Surgery

Male Breast Surgery with Just Liposuction Without Breast Gland Excision (Removal)

Liposuction can only remove fat cells and reduce the volume of fatty tissue, which is not effective for gynecomastia symptoms caused by glandular tissue growth. Excess breast gland tissue is a significant component in this condition and may be hard and firm or composed of a softer, fibrous network of tissue. In both cases, surgical removal of this tissue is critical for a successful outcome after male breast reduction surgery.

Only pseudogynecomastia can sometimes be treated with liposuction alone, although in many cases of pseudogynecomastia there will be excess skin that will also require surgical excision. This is because the excess breast tissue is due to fatty tissue and not the growth of breast gland tissue. Modern liposuction techniques are very advanced and include ultrasonic liposuction, tumescent liposuction, smart liposuction, and sharp liposuction cannulas. These instruments do a great job of removing fatty tissue, but they do not remove the breast glands which contribute to gynecomastia symptoms in male breast tissue growth.

Male Breast Reduction Surgery with Gland Excision and Liposuction Was Too Conservative

Many physicians take a “no-harm” approach because taking out too much tissue is more challenging to correct. In some cases, this plastic surgery procedure leaves too much breast fullness. Dr. Delgado is happy to see previous gynecomastia patients for their unique breast tissue scarring situations and goals to provide the best recommendation for gynecomastia patients.

Crater Deformity after Gynecomastia Surgery

A crater deformity is also called “sunken nipples,” a known complication of gynecomastia treatment. The three contributing factors for revision gynecomastia surgery due to this deformity are:

• Too much breast tissue was excised underneath the nipple-areola complex, causing the nipples to “sink” below the contours of the chest.
• Not enough tissue was removed from around the nipple-areola complex.
• The nipple-areola has adhered to the underlying pectoralis muscle.
• Any combination of the three above factors.

Treatment for a crater deformity will vary depending on the cause, although to create a smooth and proportional chest structure, fat grafting with fat injections can often resolve the issue. When the deformity is due to skin attached to the muscle, revision surgery will release the skin from the scar tissue. In some instances, all three techniques may be required.

Other Complications That Require Gynecomastia Revision Surgery

There are various other reasons gynecomastia revision surgery may be required. The most common include:

• Excess or loose skin requires further excision
• The fatty tissue in the armpit area does not blend into the chest contours
• Patient expectations were unrealistic

The key aspects of revision gynecomastia surgery include the excision of more breast glandular tissue, fat tissue, and on occasion, additional skin. The goal is to create a balanced, natural, and well-contoured chest. In all cases, Dr. Delgado will discuss your expectations and customize your correction to ensure an optimal outcome.

Gynecomastia Revision FAQs

What is the cost of gynecomastia revision surgery?

Most plastic surgeons will offer to perform revision surgery in the first year following gynecomatia surgery if the patient is not happy with the results. Dr. Delgado advises that you speak with your original plastic surgeon before contacting him to discuss gynecomastia revision surgery.

Gynecomastia revision surgery costs depend on the complications that need to be corrected. Sometimes revision surgery can be performed under local anesthesia. However, in most cases, a general anesthetic is needed to provide Dr.Delgado with sufficient time and for the highest level of patient comfort. As a general rule, a gynecomastia revision surgery procedure under local anesthesia will cost around 25% of the original surgeon’s fee. When a general anesthesia is required, it will cost around 50% of the initial cost of gynecomastia surgery.

 How do you get rid of scar tissue after initial gynecomastia surgery?

Scar tissue is formed as a natural part of the tissue healing process. Initially, scar tissue is firm and tight, which may lead the patient to think that the gynecomastia is recurring. Scar tissue maturation can take up to four months or more. During this time, regular massage should help to soften the scar tissue. When scar tissue does not become softer over time, a steroid injection administered by a Dr Delgado will usually soften scar tissue and reduce the appearance of the scar.

How long do you have to wait for revision surgery after initial gynecomastia surgery?

Swelling can take up to a year to completely dissipate, and scar tissue will normally continue to soften. This is why Dr. Delgado’s advice is to wait at least four months after an initial procedure before considering gynecomastia revision surgery

What is a gynecomastia hematoma or seroma?

A hematoma is caused by a collection of blood, and a seroma is due to a collection of fluid. Hematomas and seromas are two of the most common complications with gynecomastia revision surgery. The hematoma rate is approximately between 4% and 8% following gynecomastia surgery. Symptoms of a hematoma include pain, bruising, and swelling. Treatment will requires surgical evacuation to remove the blood and control the bleeding, drains are then placed to prevent further complications.

How long does it take to recover after gynecomastia revision surgery?

The recovery period after gynecomastia revision surgery is usually similar to the recovery period following initial gynecomastia surgery. Patients that only require a small amount of additional breast gland and fat tissue removal may find the recovery process a little faster and easier.

• In most cases, pain can be well managed with over-the-counter painkillers.
• Patients normally return to work or daily activities within a week, although strenuous activity and lifting should be avoided for around four to six weeks after revision surgery.
• Most patients will see an improvement within four to six weeks, with swelling and bruising decreasing significantly during this time.
• Temporary numbness may be experienced for 2-4 months However, full sensation will normally return to the nipples and chest area within a year of revision gynecomastia surgery.

What is the patient satisfaction rate after revision gynecomastia surgery?

The patient satisfaction rate varies and will depend greatly on the surgeon’s skill. Around 40% of the gynecomastia surgery performed by Mr. Delgado is for revision procedures, and he is highly proficient in the correction of complications or disappointing results.

Can I have scar revision after gynecomastia surgery?

Scar revision procedures are rarely necessary, as there is a range of ways to reduce the appearance of scars without the need to excise and resuture the original scar. When scar revision is required, it is done with a local anesthetic.