Pectoral Implants, Abdominal Etching and Gynecomastia Reduction

Q: Dr. Eppley,  Is there anything extra that can be done to make the abdominal etching more visible?

I’ve done extensive research into the pec implant procedure – and am still not sure whether the square or oval shape implants would be more appropriate for me. I’m looking for a nice lower pec and medial line of definition, and strong chest fullness throughout.

There are a couple of concerns about the pec implants and gynecomastia excision that I do have as well:

•In many thin patients with mild puffy nipples like me there have been issues of contour dips of the nipples – I’m just wondering if this can be prevented because we are looking at doing pec implants at the same time

•I’m concerned over how natural pec implants feel to the touch, as I don’t want people to see me shirtless, touching my chest that my pecs are fake

•Also – do the pec implants move fluidly with the pectoral muscle – i.e. contracting or moving up when tensing the muscle or, say, moving the arms upwards? I’m basically wondering how naturally pec implants move, as I’m confused if the implant fuses to the chest wall and remains fixed.

•I do have lots of armpit hair, so I’m wondering how percievable the scars from the puffy nipple removal and the pec implant insertation through the armpit would be – as I’ve seen some deep scars that are even visible when viewed straight on. Is it possible for the scars to become visible so no-one would know I’ve had surgery?

As for the ab ethching, I have seen some people where their etching looks very fake, usually in larger men. So I’m wondering how natural we can make my ab etching, otherwise there might be little point in the procedure.

I’ve not, in general, seen many plastic surgeons attempt pec implants, gynecomastia reduction and liposuction in one case  so I was wondering how many cases you’ve dealt with in each of these areas, and how I can optimise my surgery for maximum difference from my form today.

A: In answer to your abdominal etching, pectoral implants and gynecomastia reduction questions:

1) There are no magic methods to make abdominal  etching more visible.

2) There is no question, you and about every male, wants the square/rectangular style….never the oval shape.

3) Contour depressions occur in open areolar excisions because of over resection of tissues…the key is to not take too much tissue.

4) Quite frankly an implant in the body is fake….it is not natural and will never feel exactly as soft as the pectoral muscle.

5) Pectoral implants do not interfere with muscle movement as they are in a subpectoral (under the muscle) placement.

6) Axillary incisions generally heal very well, particularly with hair present with regrowth afterward. But no surgeon can make an incision and have no scar, that is not realistic.

7) Abdominal etching in thin people looks more realistic than in thicker abdomens which would not normally have it.

8) It is very common in my experience to do all three procedures at once. There is nothing rare about that combination as that is often what the patients needs. (you being an example)

Dr. Barry Eppley

Indianapolis, Indiana