California's Top Gynecomastia Expert

Voted "Best Plastic Surgeon" 2016-2020 by San Francisco Magazine

Blog

« Back to Blog

Category: Gynecomastia scars

Gynecomastia Surgery After Weight Loss

 

After significant weight loss, gynecomastia sufferers have an additional issue to deal with. Besides reducing male breasts, there is now redundant, tissue, fat, and skin requiring more contouring and skilled techniques.

2 Stage Gynecomastia Surgery

Some men are candidates for the 2 stage procedure. The first stage removes breast tissue and fat under the skin. The second stage is a minor procedure that can be done in the office under local anesthesia. Excess skin is removed around the areola in a doughnut shape and is closed with a purse-string type sutures.

Before and After Stage One Gynecomastia Surgery

Before and After Stage One Gynecomastia Surgery

 

He is seen two weeks after Stage Two Surgery

Massive Weight Loss and Gynecomastia

For men who have had massive weight loss, most will likely not get desired results with the more traditional procedure of removal of fat and tissue with a hidden incision around the areola. Instead, for the more severe cases, the patient may need an incision going around the areola and a vertical incision to the breast crease creating an anchor reduction.

The anchor incision, also known as an inverted T, will leave visible scars. Most patients understand the trade-off and are accepting of the procedure in order to obtain the best breast shape.Male chest After weight Loss

Male Chest After Weight Loss 

After gynecomastia surgery

After Gynecomastia Surgery

 

Many patients find their incisions heal nicely and are comfortable with their results. For others, it is possible they may develop keloid scars which are raised and can be quite noticeable.

Scar Care After Gynecomastia Surgery

Today there are several different treatments available to help with scar management. The experienced board certified gynecomastia specialist will use deep suturing techniques to reduce tension on the skin that helps avoid keloids. Once the incision has healed silicone sheeting is applied, it will help keep the skin hydrated, which helps in scar control.

Additional preventive measures include; steroid injections, scar massage, and laser treatment such as the Palomar Laser. As a last option, scar revision may be done, but that will involve another incision.

Call Today!

Gynecomastia patients are encouraged to call Dr. Miguel Delgado at (415) 898-4161 for a consultation.

Gynecomastia Scars after Male Breast Reduction Surgery.

 

A disappointing result after gynecomastia surgery is poor quality gynecomastia scars after male breast reduction surgery. Many treatments can improve the quality of the incisions. 

As with all surgeries, incisions that result in scars can not be avoided. Many factors go into the formation of a scar.

  • Genetic predisposition – some people are programmed to form keloid or hypertrophic scars.
  • Tension – a high amount of tension on the scar will create forces to pull at the incision and creates more scar tissue.
  • Location of the scar – If the scar is on very mobile areas like the shoulder, chest, or knee the scar then to be much worse
  • What is the scar due to – Is the scar injury formed by a control instrument like is scalpel or from a burn, crush injury, etc.
  • Ethnicity – Pigment in the skin will create more color variation in the scar and sometimes surrounding the scar. The pigment melanin can play a significant role.
  • Sun Exposure – early sun exposure can affect the skin pigment of the scar in the initial healing phase.

Gynecomastia Scar Characteristics

The gynecomastia scar is created in a unique hidden area. It is the lower half of the areola, where the areola and normal skin pigment meet. The incision is called a Webster incision. This surgical approach is the exact incision for breast augmentation!

Webster surgical incision underneath  the areola

webster incision- gynecomastia incision

The gynecomastia scar is not under skin tension as it heals, and this encourages proper quality healing. The pigment will vary from patient to patient, and another essential factor is the grade of gynecomastia or the size of the condition. The Webster incision can be very short and is determined by the size of the areola. If the gynecomastia’s grade is 2-or 3, the incision can be more traumatized by operating through a small incision with a lighted retractor. The stretching of the skin can affect the quality of the scar.

 

When will the scar be completely Healed?

The initial healing will take place in a few weeks. This is when the sutures are removed and the scar tissue has bonded the edges together. The final outcome is not seen for nearly a year. This is when the scar tissue has completely softened and the pigmentation is set for life.

How to Treat Poor Gynecomastia Scars?

It is unknown why some people are more susceptible to scar formation than others. Scars are a natural result of the body healing itself when there has been trauma to the skin. During the initial healing process, the body produces collagen fibers that will end up having a different texture than the surrounding skin. Sometimes the body will overproduce collagen, creating a buildup of tissue, resulting in a firm raised scar known as keloid or hypertrophic scars.

 

Skin incision Before and After Scar Treatment

Before and After Scar Treatment

In many cases, it is not medically necessary to remove these benign scars. However, if they are noticeable, they may cause a lot of discomfort to the gynecomastia patient who wants to go shirtless after surgery.

There are several options available for scar removal, including; steroid injections, silicone sheet or gel therapy, and laser treatment, such as the non-invasive Palomar Icon Fractional Laser. The last option is very simple scar revision and under local anesthesia.

Having a Board Certified Plastic Surgeon who specializes in gynecomastia is your best bet for avoiding noticeable scars. Patient participation in preventing unsightly scars is crucial. Be sure to follow your doctor’s post-operative instructions that should include; avoiding direct sunlight for six months to a year. Sunlight is known for contributing to hypertrophic scars. Using silicon sheeting once the incisions have healed have proved to be very beneficial in scar prevention.

 

Man Standing with before and after photos of gynecomastia surgery

Before and After Gynecomastia Surgery

If you are struggling with unsightly scars after gynecomastia surgery, schedule a free consultation today (415) 898-4161 with Dr. Miguel Delgado, M.D. to find what options are available to you for removal.

Gynecomastia Consultation Questions

Gynecomastia questions

For men who have hidden the embarrassing condition of female type breasts, making an appointment to see a gynecomastia specialist is a big first step. It is understandable for gynecomastia patients to be anxious and therefore, Miguel Delgado, M.D. recommends writing down all questions as it is easy to forget what you want to ask. However, Dr. Delgado wants his patients to know that he is easily accessible and encourages his patients to call (415) 898-4161 anytime they have a question.

The following questions are some you may want to consider:

1. Is your gynecomastia specialist board certified?
2. Is the anesthesiologist board certified?
3. What type of anesthesia is used?
4. If surgery is to be done at a surgery center, is it accredited?
5. How many years has your specialist been performing male breast reduction, and how many each year?
6. What caused my gynecomastia?
7. How long will my male breast reduction last, and will it come back?
8. How would my surgery be done?
9. Will liposuction alone work for me?
10. Where will the incisions be? Will the scars show?
11. What prescriptions will I need? What are they for?
12. How long after surgery before I can go home?
13. Will I have drains?
14. How long will I need to wear a compression vest?
15. How much time do I need to take off work?
16. When can I start lifting weights?
17. What risks does the surgery have?
18. How are complications handled?
19. Can I see before and after pictures of gynecomastia patients?
20. What is the cost?

Getting answers to all of your questions will ease your anxiety and ensure a positive experience. Dr. Delgado states that the only complaint he has received from his male breast reduction patients is that they wish they had their surgery a long time ago! Start today by calling (415) 898-4161 for your initial consultation!

How Visible are the Gynecomastia Scars after Surgery?

drain-scar - photos before and after

The gynecomastia scars from the drain before the new technique.

For the San Francisco Bay Area man, in order to remove male breast tissue and fat during male breast reduction surgery, an incision is made at the bottom half of the areola, between the darker and lighter skin. When it heals the gynecomastia scar is almost invisible. Chest hair can also help in hiding the incision. The healing process can take up to 6 months to a year.

I recommend silicone sheeting about 10 days after the gynecomastia scars are healed. Silicone sheeting helps soften and lighten the color of the gynecomastia scar. I also do a tiny incision in the armpit for the liposuction cannula and for the drain.

My San Francisco patients let me know that the tiny scar left by the drain under the arm was a point of concern, now by a new technique I place it high up in the armpit toward the back, most of my patients have a hard time finding it.

Depending on the severity of the gynecomastia grade this will determine the type of incision, sometimes it can be less, in some cases, it can be more if a second stage reduction is needed.

Scar Care after Gynecomastia Surgery

With all of the issues to consider when contemplating gynecomastia surgery, the question of resulting scars comes up often. This is understandable as men who want to get rid of their male breasts, don’t want to trade for another unsightly result.

It is extremely important to be sure your surgeon is an expert in gynecomastia surgery. Dealing with the resulting scars from male breast reduction surgery is secondary to the correct placement and technique of the surgical incisions. By placing the incision at the bottom of the areola most men find it difficult to see any resulting scar after all healing has taken place. However, to ensure the best possible result, Dr. Delgado has his patients use silicone gel sheeting about 10 days after the incisions are completely healed. The silicone helps soften and lighten the color and appearance of the scars. Silicone Gel Sheeting - pic

Directions for using the silicone gel sheeting are as follows:
1. Cleanse and thoroughly dry the scar area.
2. Cut a piece of the silicone sheeting slightly larger than the area of the scar.
3. Apply the adhesive side directly to the area and secure in place with tape or bandage.
4. Clean the silicone sheeting and the scar area on a daily basis using mild, non-oil based soap (Ivory or Neutrogena soaps are recommended). The silicone sheeting may be reapplied to the scar until the patient notices excessive wear or reduced adhesion and then a new strip of silicone sheeting should be administered. Product wear will depend upon the scar location and patient activity level. Typically, the silicone sheeting should be replaced every 10 to 14 days.
5. For best results, the sheeting should be worn 12 to 20 hours per day.
6. The surgeon is responsible for determining the treatment time for the patient. Generally, the minimum duration of treatment is 4 to 12 weeks.

Sun exposure on the healing incision must be avoided for the first few months. The sun can cause the pigment of the skin to darken and the tissue may thicken. Keep the scar covered with clothing or a bandage.

OVER 1000 BEFORE & AFTER PHOTOS
SHIRTLESS IS A GOOD THING line-border - pic See how Gynecomastia Surgery Has Changed The Lives Of Men

Get The
Latest News

line-border - pic

Read Our Blog

Gynecomastia
Surgical Videos

line-border - pic

View Videos

SAVE TIME WITH A FREE VIRTUAL CONSULTATION WITH DR. DELGADO


UPLOAD YOUR PHOTOS

Contact Us

Please feel free to fill out the form below for a price quote or to contact us with any questions or comments you may have.

Dr. Delgado has offices in Marin and San Francisco for your convenience

San
Francisco

line-border - pic

450 Sutter Street Suite 2433
San Francisco, California 94108
(650) 405-0154

[ DIRECTIONS ]

Marin
County

line-border

165 Rowland Way Suite 300
Novato, CA 94945
(650) 484-5416

[ DIRECTIONS ]

travel package - banner
website - picture
Top