Gynecomastia revision candidates sometimes ask us about odd looking craters and dents when they flex without realizing these features of post-op man boobs are called “animation deformities.” It’s worthwhile exploring this topic because it’s not often talked about related to male breast reduction.
In fact, if you search for information on the Internet, you’ll find that most discussion of animation deformities relates to breast surgery for women. What the term refers to in this case is a misshapen look that occurs with muscle activation, particularly when women with scant breast tissue receive breast implants. To guard against this result, plastic surgeons consider implant placement carefully when performing breast reconstruction after mastectomy and for female body builders and those who are very slim. For these women, implant placement above the muscle is often a good choice to avoid distortion when the pectorals are flexed.
For men who have had gynecomastia surgery, the situation is a bit different. (After all, most guys don’t have implants.) But it’s not unusual for us to meet a guy thinking about gynecomastia revision with us whose surgical results appear pretty good at first glance. When these patients flex their muscles or raise their arms over their heads, that’s when the unfortunate craters and valleys appear. The chest normally changes shape when the arms are raised above the head or the pec muscles are flexed, it’s true. The difference is that after poor surgery, craters can form which are not evident when the arms are at the side.
So, what’s the big deal, you might ask? Men don’t typically walk around with their pecs flexed or their arms held high. If the man boobs are gone, then isn’t that good enough? Some guys reach that very conclusion. Others find that after suffering with enlarged breasts for years, then gearing up for male breast reduction, results that aren’t as good as they could be just don’t cut it.
In our view, the one and only time animation deformities happen is when a less experienced plastic surgeon removes too much tissue—usually breast gland—in one location. This causes a lack of support in that area, and the remaining tissue caves in when the muscles are engaged. For some guys the indentation is slight, for others, the deformity is much more noticeable. One guy we talked with via the forum on gynecomastia.org said that when he flexes his “nipple literally points at the ground.”
The patient who bemoaned his animation deformity on gynecomastia.org noted that his original plastic surgeon recommended liposuction as a possible treatment. We would not likely choose this option, because even though removing more tissue would smooth out the difference between the surrounding area and the crater, there would be even less support for the patient’s nipple/areola complex.
For most of our gynecomastia revision patients, we favor using fat flaps to fill craters. This means we gently loosen a “tongue” of fat nearby and reposition it in the indentation. If there’s not enough fat in the surrounding area for this approach to work, another alternative is to harvest fat cells from another part of the body and inject them. The goal is to provide a uniform layer of fat to allow the chest skin to slide over the pectoral muscle smoothly, without the valleys and tethers that can cause deformities.
Gynecomastia revision patients who have been disappointed with the outcome created by another surgeon are a large part of our patient base. Since we’ve been helping many thousands of guys with man boobs for more than thirty-five years, it’s possible we may have more experience with primary and revision gynecomastia than any other practice in the country. Our reputation for handling challenging cases of gynecomastia in South Florida has grown, and it gives us great satisfaction to improve results that have crushed a patient who was hoping for something more.
If you’re bemoaning your post-gynecomastia surgery appearance, contact us. We’ll be glad to give you our expert, honest assessment. Chances are we’ll tell you we can make your chest look much better, but perhaps not “perfect.” And if we feel we can’t do that, for whatever reason, we’ll tell you that too.
Dr. Elliot William Jacobs is a board-certified aesthetic plastic surgeon who specializes in FTM top surgery, gynecomastia surgery, revision gynecomastia surgery and male breast reduction. He is a native of New York and has over 40 years of experience in his field. Dr. Jacobs is a highly respected and sought-after surgeon who is known for his skill, experience, and compassion. Whether you are interested in gynecomastia for the first time, or are looking to correct a gynecomastia you aren’t happy with, Dr. Jacobs can deliver amazing results.
DR. ELLIOT JACOBS M.D., F.A.C.S., F.I.C.S
Reach out to Dr. Jacobs today to schedule your consultation!