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Blog. Real Patient Question: Who Pays for Gynecomastia Revision?

When a post-male breast reduction surgery patient is dissatisfied with his results, it can be a tricky situation for both the man and the surgeon. The patient can be understandably upset, having committed to cosmetic surgery with high anticipation only to be disappointed with the outcome. Plastic surgeons have the best of intentions and will also feel dismay when a patient is unhappy. It can be challenging for both parties to be completely calm and objective and have a productive conversation about what to do.
We recently answered a member of who asked the question online, “Who pays for botched job?” We’ll share our thoughts here in case other patients or prospective patients are wondering about this.

Taking a Step Back

Noticing the use of the word “botched” in the question, our first input to the patient was to consider why surgical outcomes don’t always turn out beautifully. Sometimes, yes, it can be due to a mistake by the cosmetic surgeon. Other times, patients don’t follow pre- and post-op instructions. Most often, however, less than ideal results are due to the capricious nature of Mother Nature and the healing process.
Taking these possibilities into consideration may help a patient have a fruitful meeting with his plastic surgeon to evaluate results. Fortunately, in most cases revision gynecomastia surgery can provide a second chance.

So, Who Should Pay?

There is no standard practice when it comes to charging for gynecomastia revision. Some plastic surgeons charge for revisions, some don’t. Most doctors’ policies probably fall somewhere in-between.
For our patients, we provide a written policy to read and sign prior to male breast reduction. In it, we state that we will provide free surgical services for a revision procedure within a year of surgery, provided:
• Both surgeon and patient agree that fine tuning of results is indicated, and
• The patient agrees to pay modest charges for anesthesia and the OR.

The Caveat

Those with a cynical streak may believe that the first caveat—that both patient and doctor must agree—is part of the policy to allow us to avoid gynecomastia do-overs. No so! We absolutely want our patients to be satisfied with their experience. Not only that, we take great pride in our work and our reputation.
We insist that both parties agree for a few reasons. First, we want to be sure that adequate healing has occurred. This takes several months. And, when scar tissue is the problem, sometimes the most appropriate course of action is cortisone treatment instead of surgery. Finally, the patient may be expecting absolute perfection that is unrealistic and further surgery might make things worse rather than better. In these instances, our 35+ years of experience with gynecomastia surgery should weigh most heavily in the final decision.

What Patients Can Do

If a patient should question our recommendation about gynecomastia revision, we invite them to seek a second opinion from another board certified gynecomastia surgeon. We feel doctors should welcome the judgment of other seasoned professionals.
But the best way to handle the possibility of gynecomastia revision surgery is to prepare ahead of time. Our most important advice to any guy considering surgery for man boobs is to first understand his own expectations for results and make sure those are in line with what’s possible. Then, ask about the plastic surgeon’s revision policy ahead of time.
We perform gynecomastia surgery for hundreds of guys each year. Some of those are revision procedures. Most often we revise other surgeons’ results, but occasionally we see the need to adjust our own work. Since we are highly confident in our experience and our team and the huge majority of our patients are very happy after surgery, we are not reluctant to agree to a do-over if we believe we can improve an outcome. Contact us to see if we can help you!


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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