How Can I Correct My Crater Chest Deformities After Gynecomastia Reduction Surgery When Secondary Fat Injections Did Not Work?
Q: Dr. Eppley, Looking to correct previous gynecomastia surgery. I have bilateral surface irregularities/depressions and scar tethering during flexion. Original surgery completed one year ago with fat grafting completed six months later. Pre and post pictures included.
A: Thank you for your inquiry and sending your pictures. As I understand your history you had an open areolar approach to your gynecomastia reduction complicated by a postoperative crater deformity. This was followed by a second surgery of fat injections in attempt to release the adhesions and improve the contour.
Fat grafting as a treatment for the crater deformity after gynecomastia reduction is an appropriate approach. One can debate whether that should be by injection or the open placement of a dermal-fat graft. Each has their advantages and disadvantages. Fat injections are a more simplified and convenient approach to the problem but how much survives and their contour effectiveness is very unpredictable and far from assured. Dermal-fat grafting is more effective in terms of a successful release and volume retention but it is an open surgery and involves the need for a donor site harvest.
Most surgeons and patients when presented with the two options would understandably opt for the fat injection method. The question moving forward is whether another effort should be made at fat injections or whether one feels better about moving on to a ‘Plan B’ correction method. I can make arguments either way.
Dr. Barry Eppley