One major cause for gynecomastia revision surgery is when too much of the male breast tissue has been removed leaving what is known as a “crater deformity”. A crater deformity is as it sounds a crater or depression under the nipple/areola complex with inadequate blending of surrounding tissue for a firm smooth contour.
Fortunately there are procedures that can correct the crater deformity. First, the patient must wait until he has completely healed from the original surgery. In general the fat flap is the best choice and has become the most predictable; this is where the skin is elevated and the fat that surrounds the crater is sewn together filling in the depression. Sometimes the use of fat injections also known as fat transfer or fat grafting can take place but it all depends on the architecture of the defect.
It is important for the gynecomastia patient to find an experienced Board Certified Plastic Surgeon. A secondary procedure is much more difficult due to scar tissue that has formed which makes the dissection more difficult and healing less predictable. In addition to the complication of scar tissue, the skin usually does not contract as well as the first time around. I would say that 35% to 40% of my gynecomastia procedures are revision surgeries.
See video of “post-surgery” in a blog dated April 2, 2012.