Author Topic: Will CT Scan Show Gynecomastia Surgery Scars?  (Read 4964 times)

Offline bobby81

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I had gynecomastia surgery, and then a revision about a year ago. Was wondering if the scars will show up in a CT scan of the chest I'm having for an unrelated issue. Please let me know, Thanks.



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Online Dr. Elliot Jacobs

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Unless there is a large amount of scar tissue, it would probably not show up on a CT exam -- CT usually looks at bones.  On the other hand, if an MRI were to be done, then scar tissue might be revealed.

Dr Jacobs
Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
815 Park Avenue
New York, New York 10021
Telephone:  (212) 570-6080
Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.com/revi

DrBermant

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I had gynecomastia surgery, and then a revision about a year ago. Was wondering if the scars will show up in a CT scan of the chest I'm having for an unrelated issue. Please let me know, Thanks.

Here is a similar question posted here about the more general issue:

Hey everybody,


I had my gyno removed june 2009 lipo & gland. One of the best moves I have ever made.

   I have since hurT my chest playing football, they want to do a chest x ray, will they be able to tell on the x ray that I have had gyno
surgery ?  I am not really wanting even my family doc to find out when he gets the results from the chest x ray.

Please help


Thanks,


It depends on the type of Xray being done. Xrays show radiodense tissues, that means tissues that do not let the radiation pass as well. Normal chest xrays tend to show mostly bone and some lung detail. Gland and scar tissue can show up but tend to get lost in the clutter. Xrays designed for the breast, mammograms, will show gland and scar tissue, but it can be difficult to see that surgery has been done unless it is one of the bad complications that come to me unhappy after surgery by other doctors. More revealing would be CAT scans which also use xrays and a computer where you can dial into the tissue density needed to show the structure. I have used CAT scans to see disrupted muscles, scar tissues, and residual gland when there fortuitously (I do not order that test, but will use it when another doctor orders it for something else). MRIs use a different spectrum of the radio waves, magnetic fields to analyze  tissues. Muscle, gland, scar tissue all show up well on this test but it would take a trained eye to see if surgery was done, again except if there was a disfiguring deformity after surgery. That is something I have ordered to understand the deformity made in muscles by surgeons from complications of their gynecomastia surgery.

Although I did not order them, I had the opportunity yesterday to evaluate a series of mammograms and MRIs ordered after gynecomastia surgery done elsewhere. The mammograms, one before and the second after the first surgery show the damage to the muscle done by the first surgeon in one state. He injured the muscle so bad that a section was left paralyzed. It also showed the residual gland left by the liposuction only technique, but you cannot distinguish gland from scar tissue. So on that series of mammograms, yes the radiologist were able to say that something had been done to injure tissue. And yes, the mammograms are xrays. The MRIs were done after revision surgery done in another state. The MRIs will show scar tissue, residual gland, and deformed muscle. I could see the deformed muscle but do not feel comfortable committing that the tissue I saw was denser scar tissue or what, such interpretation I leave to a radiologist and I did not bring that patient's films to a radiologist to get that section interpreted. That is what I do when I think I have a chance of reconstruction and am trying to use whatever I have at hand to better understand the anatomy or if surgery should be done. I did not use the MRIs to make that call yesterday, that was done by clinical exam and documenting tissue moving on animation and videos. That patient had been over liposuctioned, the crater defect so extensive, that I did not have a reasonable option to rebuild his chest. On cases in the past, such a visit to radiologist permitted me to understand the disrupted muscle left by that other doctor and then I was able to perform a reconstruction of the chest wall by repairing the damaged muscle, removing the scar adhesion, and using local resources to rebuild the chest.

So, in answer to your question, it depends on the specific type of test ordered and how cleaver the radiologist / viewer are who are looking at the test. It is highly unlikely that a regular chest xray will show anything, but a more refined use of radiation such as mammogram, CT scan, or MRI (different spectrum but still radiation) may show evidence of surgery to someone looking for it.

As far as the CT scan being ordered, it is just a matter of changing the density settings on the monitor to the type of tissue of interest. I can do it myself with free software from the internet and have done so as a teaching tool for my patients when they bring in a scan on disk. Significant scar tissue, residual gland, disrupted muscle, permanent sutures, will all show up. However, most are not looking for what can be subtle issues. The cases I am describing above all had deformities that they were coming to me for.

Hope this helps,

Michael Bermant, M.D.
Board Certified
American Board of Plastic Surgery
Member: American Society of Plastic Surgeons and American Society of Aesthetic Plastic Surgeons
Specializing in Gynecomastia and Surgical Sculpture of the Male Chest
(804) 748-7737


 

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