What Do I Do With A Crater Chest Deformity After Gynecomastia Reduction?

Q: Dr. Eppley, I have crater chest deformity. I had not long ago had gynecomastia reduction surgery and it’s gone horribly wrong. My nipples are caved in and they are partially black. I am devastated. What do I do now?

A: Thank you for the clarifications and sending your pictures. What you have is an over resection of tissue through an open gynecomastia reduction approach that has left both a crater deformity as well as partial nipple-areolar necrosis. While I don’t know exactly how long ago the surgery was I would suspect on the appearance of the nipple-areolar complexes that it as just a few weeks at longest. 

Your options at this point are the following:

1) Let the extent of the crater deformity and nipple-areolar necrosis declare itself (the extent iof the contour deformity and how much the nipple-areolar complex will survive) over the next few months and then treat secondarily with fat grafting and nipple-areolar scar revision, or

2) Undergo immediate injectable fat grafting to help restore the contour and possibly limit the extent of the nipple-areolar tissue loss. (what is black is likely full-thickness tissue loss) This still may require some revision later but by adding healthy tissue back in with some stem cells it will expedite the healing process as well as provide some early contour improvement.

Dr. Barry Eppley

Indianapolis, Indiana