Gynecomastia Revision

February 1st, 2017 | Posted in: Gynecomastia Treatments | Tags: gynecomastia surgery, male plastic surgery, plastic surgery in Beverly Hills

With any surgery, there is always the risk of needing revision surgery. Due to diet, genetics, or use of certain medications and drugs, some men may eventually gain back their enlarged breasts, or, in other instances, men who didn’t get the results they were looking for the first time around may desire to undergo a secondary procedure to further their appearance.

Whatever the reason you may have for wanting to undergo gynecomastia surgery, here are some things you need to know before receiving your plastic surgery in Beverly Hills.

What is Gynecomastia?

Gynecomastia is a benign enlargement of the male breast (usually bilateral but sometimes unilateral) resulting from a proliferation of the glandular component of the breast. It is defined clinically by the presence of a rubbery or firm mass extending concentrically from the nipples. Gynecomastia should be differentiated from pseudogynecomastia (lipomastia), which is characterized by fat deposition without glandular proliferation.

Many surgeons perform pseudo gynecomastia surgery using the liposuction technique without breast gland excision.

Reasons for Revision Surgery

With gynecomastia surgery, the need for revision surgery typically falls under one of two categories: under-resection and over-resection. Both types of patients have different challenges, but by far, the more difficult revision procedure is in those patients who have been over-resected.

Under-resection

The under-resected patient is unhappy because he feels that he still has fullness in his chest. After going through surgery, the cost, and the recovery, the patient is typically very disappointed and upset that he has to go through the entire process again. It is important to determine whether the fullness is due to excess breast or fatty tissue that was not removed during the original operation or whether it is the development of scar tissue that gives the appearance and feel of glandular tissue. Either way, the patient will likely need another surgery to address the issue.

Over-resection

The over-resected patient pose a more difficult challenge, mainly because they usually have contour abnormalities. They will likely have dents, tethering of the areolas to the muscle, and flexion deformities (i.e. when they flex their pecs, the underlying skin or areola caves in). These patients may also be under-resected in other areas if their chest, which will make the over-resected areas much more pronounced.

Typically, the only options for these patients, aside from silicone implants, are getting fat grafting or fat flaps. Fat flaps, which refer to rotating the fat from the adjacent area of the chest to the dented area without separating the fat, can only work if there is enough fat to rotate. Free fat grafts involve harvesting fat from another body part (abdomen or flanks) and injecting it into the dented areas. This may help, but it is unpredictable how much fat will survive. This is because fat grafts need a blood supply to survive and the dented area usually has scar tissue with an unpredictable blood supply. Therefore, patients who require fat grafting may need more than one surgery to get the best result possible.

Other issues in over-resected patients are inverted nipples and tethered scars. These are more easily corrected than severe dents.

Gynecomastia Revision Surgery

Gynecomastia revision is a minimally invasive procedure that involves the use of liposuction and excision to restore a firm and attractive appearance to the breasts. This procedure is performed on an outpatient basis under intravenous sedation or general anesthesia. The placement of the incisions on the chest will depend on preference and the severity of the enlarged breast.

After the correction incisions are made in the targeted area of the breasts, a cannula (thin hollow tube) will be inserted underneath the skin. As the cannula is gently moved back and forth, fat deposits are separated from the muscular tissue and removed through vacuum suction. In some cases, excess skin and glandular tissue may also be present and require removal. As skin is excised through inconspicuous incisions, the remaining tissue is sculpted to a better contoured physique. After the desired amount of fat and skin tissue is removed, the incision will be closed with sutures.

Recovery and Your New Look

After the gynecomastia revision surgery is complete, the chest will be dressed with bandages and a compression garment to help reduce swelling and bruising. Patients may feel some pain and discomfort for a few days, but symptoms can be alleviated by prescribed medication. Many men feel they can return to work after four to seven days, but should refrain from performing any strenuous activity and exercise for at least two weeks.

The final results will not be immediately apparent after gynecomastia revision surgery is complete; however, over the coming weeks, the chest will become noticeably more firm and contoured. Incisions are often placed underneath the chest or in the folds of the breasts to conceal any scarring that exists. The final results from this procedure can be long lasting, if you live a healthy lifestyle and maintain your weight.

Plastic Surgery in Beverly Hills

Choosing the best plastic surgeon is a big part of whether or not your gynecomastia revision surgery will live up to your expectations. If you are living in the Beverly Hills area, then you should book a consultation with Dr. Chiu to discuss your options for gynecomastia plastic surgery in Beverly Hills.