Author Topic: Gynecomastia Revision Surgery Forum - Large Nipples After Surgery  (Read 7758 times)

Offline DrBermant

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I just had gyne surgery one month ago but I do not like the look. My doctor just cut the glands out. My nipples are still large. They have been stretched for years. What options are there areola reconstruction for revision surgery? Can it be done with local anesthesia alone?

Are you asking about Areola Reduction Surgery? Areola Reconstruction is to repair defects of damaged or missing areola.

Sometimes Secondary Gynecomastia Surgery alone can help shrink expanded areola.

Areola Reduction Surgery is a significant compromise that I rarely recommend unless there is a great deal of excess skin (such as After Massive Weight Loss or in large breast Transgender Female to Male Chest Contouring.) There are many techniques to tighten the skin and remove areola, each has their own compromises.  However, flat nipples hanging well below the pectoral muscles look much worse than scars from reduction.  For major amounts of excess skin, a Skin Reduction Chest Lift may be an option.  Depending on sutures to hold areola tissues at a smaller size is a real risk as seen in the example below where I revised a mess from Australia surgeon's use of dissolvable sutures.  Permanent sutures can break, stretch, and get infected.  Such risks are better explored during a consultation after an evaluation.

Warning Graphing During Gynecomastia Areola Reduction Surgery Pictures

You can see actual pictures during a  Revision Donut Mastopexy Areola Reduction Surgery here.  

Photographs during surgery to reduce big areola continue here. and there are more Pictures during surgery to reduce male areola here.

The areola usually expands with bigger breasts.  Like a balloon, with deflation (surgery) there is a reduction in diameter unless there is a layer of remaining gland after gynecomastia surgery.  Roll your cursor over that text or image and you can see a drawing of gland that can be left behind after surgery.  I have seen many examples of gland adherent to the muscle areola complex that keeps the areola puffy and larger diameter.  That is why I prefer to target the gland first with my Dynamic Technique for Gynecomastia.

Check out the many before after pictures of this  Areola / Nipple Reduction Gallery, Areola Reduction Picture Gallery, and Pictures of Areola Reduced with Gynecomastia Surgery.  These results are typical for my sculpture of my patients.

Here is a balloon demonstration of nipple / areola shrinkage typically seen with my gynecomastia surgery.  When a breast gets bigger, so does the diameter of the areola nipple complex.  Remove tissue from the breast and it is like this balloon deflation.  However, not all tissues shrink the same.  Tissue over stretched, older patients, scars, and gland remaining after gynecomastia surgery can limit this decrease.  Here is a demonstration of deflation with areola staying the same size.  That is why I prefer to target this gland first with my surgery.

Take your time to browse through the galleries of nipple areola pictures before and after gynecomastia surgery to see actual results for my patients.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery
Michael Bermant, MD
Retired Plastic Surgeon
Surgical Sculptor, Artist, Creative Thinker, Problem Solver
Plastic Surgery
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