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Blog. Fat Grafting Can Improve Poor Gynecomastia Surgery Results

Once in a while we consult with a gynecomastia patient whose surgeon removed too much fat or breast gland. Often this results in what’s known as a “crater deformity,” or depression under the nipple/areola. Other times a man’s chest simply looks asymmetrical after surgery. Sometimes additional problems are present too, such as loose skin and poor scars.

We really feel for these patients! After agonizing over gynecomastia and going through all the preparations for male breast reduction, ending up with disappointing results can be devastating. That’s why we’re pleased to tell many men that their chest contours can be improved, either with a minor man boob revision utilizing fat flaps or with fat injections.

Although fat grafting is a relatively new procedure and there is still much for plastic surgeons to learn, we have found that with proper technique, small fat flaps or injected fat cells can indeed improve less-than-wonderful surgical results. Fat must be handled very carefully to improve the chances that it will survive in its new location.

When fat flaps can be used, they are rotated into the man boob crater to smooth it out while remaining attached to nearby tissue. Injections must be administered in thin ribbons surrounded by normal cells to help ensure the transferred fat will find a viable blood supply.

When craters are present, the patient’s body type dictates what can be done. Most guys can benefit from  the fat flap approach, and it’s one we favor to give the tissue the best chance of survival. For patients with very little body fat, like bodybuilders, or patients who just don’t want a second gynecomastia procedure, injections may be the way to go.  In this case, it’s important to relocate fat in small amounts at a time. Injecting too much at once is a leading cause of fat necrosis (death) and additional scar tissue build-up.

Working with guys who have had too much tissue removed is a challenge we find very rewarding. Each patient must be carefully evaluated in order to create the right plan. Patients with indentations may need scar tissue to be released. Patients with bulges as well as craters may need additional light liposuction. We can’t promise to deliver perfect results, especially after an initial procedure gone wrong, but we can usually improve chest contours quite a bit. Take a look at our before and after gynecomastia photos to see some of our work.

If you’ve been disappointed with the results of your surgery for gynecomastia, our consultation room awaits you! Consider coming to Boca Raton for man boob revision surgery. We have more than three decades of experience in male breast reduction, much of it performing do-overs. Give us a call at 561-367-9101 or contact us online for an appointment.


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.


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