We sometimes think of excess scar tissue formation after gynecomastia surgery as “the gorilla in the room” – not because it happens so often (it doesn’t) but because it can be tricky to deal with. And, we readily acknowledge, when unusual scar tissue appears, it can be disappointing for the patient.
Over our three decades of performing gynecomastia surgery in New York City, there’s much we have learned and can share about the topic. We are talking about scar tissue that forms subcutaneously, or under the skin, and here are some key things to know.
1. Most guys do not have a big problem with scar tissue.
You probably know that the body scars after any kind of trauma as a way to re-knit the tissues. It’s normal; there’s no way to avoid it. Patients sometimes do have slight lumpiness under the skin after full recovery from male breast reduction. Most often, though, you can’t see it, just feel it.
If you visit RealSelf, you’ll see that the “worth it” ratings for gynecomastia surgery are well above 90%. That means the majority of patients are satisfied with their surgical results.
2. Try not to judge your outcome too soon after surgery.
While you should see indications that your man boobs are flattening out soon after surgery – certainly within several days – it takes months for every bit of swelling to disappear. Therefore, you need to be patient with your body for a while. If you observe puffiness or other minor post-surgical concerns right away, it’s probably a good idea to wait a while before worrying.
Of course, if you notice something that really troubles you, or you’re not feeling well, you should call your plastic surgeon right away.
3. Puffiness could be residual gland tissue.
Scar tissue usually forms between 4-12 weeks following male breast reduction. If you notice puffy nipples before then and they persist, it could be an indication that not enough breast gland was removed, not that you have excess scar tissue.
No plastic surgeon removes ALL the breast gland tissue during gynecomastia surgery as this can cause the dreaded crater deformity. Since it takes skill and lots of experience to know just how much to remove, some plastic surgeons err on the side of leaving too much gland. In any case, if you’re not happy with your results, return to your original doctor several weeks post-op for an evaluation.
4. Lumps and bumps are usually “no-fault” occurrences.
Scarring is one of the most unpredictable aspects of surgery – any kind of surgery. While you may be aware of your body’s tendencies, even if you most often heal well you may still experience more scarring than you expect after male breast reduction. This is usually no one’s fault, not yours and not your cosmetic surgeon’s.
5. You have options.
If you and your plastic surgeon determine you do have significant scarring, you might choose to do nothing, have injections to reduce lumpy tissue or have minor corrective surgery. Your doctor should be willing to work with you to some extent on fees.
If you have lost confidence in your original cosmetic surgeon or if you just want a second opinion about results and options, by all means, arrange a consultation with another doctor – one who’s an expert on man boobs.
There’s a reason plastic surgeons speak with their patients so often about realistic expectations: the outcome of cosmetic surgery can never be 100% predictable. The more experience your plastic surgeon has and the more you follow their instructions, the better. But the human body can be fickle!
Think over your expectations before heading into the operating suite. Is your body perfect? How about those long middle toes you have? Or your lopsided smile? Or your slightly crooked nose? If you expect to look “much better,” not necessarily “perfect,” after surgery, then scarring is not something to worry too much about.
You can get a better handle on this and other aspects of surgery during a personal consultation. Contact us online or call 561-367-9101 if you’d like to pay us a visit.

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