This is an example of a secondary gynecomastia surgery, also known as revision gynecomastia surgery. He complained of continued fullness of his chest. I treated him with my standard approach and modified my technique depending on what I engaged at surgery. He had a lot of very dense, adherent scar tissue bilaterally but more so on the right side. This scar was removed and internal flaps were used to pull “normal” tissue under the nipple areola complexes so there are no depressions or contour deformities to be seen.
He is seen here about 9 months out of treatment and he is doing well. I have given him some periodic steroid injections for scar tissue softening. His chest contour is improved tremendously and he is happy. You can see that the flexion creases on his upper abdomen are now gone because of his improved posture (he no longer bends over at the upper back to hide his chest). His head is in a great place and he is pleased with the results.
Revision surgery is sometimes straight forward with the removal of tissue that wasn’t removed at the original procedure. Unfortunately, this is not uncommon and often based on misconception that tissue must remain so there is no depression or contour deformity OR it’s surgeon inexperience in not being familiar with the ideal “end point” of surgery so the patient is happy with his result. SmartLipo has been associated with significant challenging scarification that makes treatment very complicated. It’s always best to make sure your first treatment is the last treatment that you will need so seek out the most experienced surgeons.
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