How Do You Avoid The Crater Deformity When Doing Gynecomastia Surgery?

Q: Dr. Eppley, In reading about gynecomastia surgery, there seems to be an issue about the doctor removing too much tissue thus developing a “crater” look to the chest with fat pockets under the breast.  How does the doctor address this?

A: The best way to avoid that problem to be aware of it and not create it. When deciding how much breast tissue to remove in an open gynecomastia operation, it is a matter of pure judgment. There is no scientific way to really know how it will look until it heals based on how much tissue is removed. Because an open procedure has the potential to remove more of the breast tissue in a central position (under the nipple) than around the perimeter, it is important to not over resect (remove too much) from this area.Since solving the gynecomastia crater deformity is more challenging than having to take more should a revision be needed, it is always better to use caution rather than indiscriminate aggression in gynecomastia reduction.

Dr. Barry Eppley