Scar Tissue Formation After Gynecomastia Surgery: Common Things Occur CommonlyAustin Gynecomastia Center

My essential gynecomastia paper published in 2022 found that the most common reason for a revision procedure was the development of scar tissue. This had never been mentioned in any prior literature regarding complications of gynecomastia treatment. So if you are considering gynecomastia treatment, what does this mean for you?

Not all gynecomastia treatments are performed in the same manner. This means not all results are the same—nor should they necessarily be. What is the best result from gynecomastia treatment? Should tissue remain so there is a better contour of the chest? Is it necessary to remove all the tissue? A masculine chest is in the eye of the beholder.

At the Austin Gynecomastia Center, all gross gynecomastia tissue is removed. This is the firmer tissue centered at each nipple-areola complex (where it originates). By removing all the tissue, I ensure that the nipple-areola complexes are flat and no longer puffy. Tissue removal with additional sculpting of the fat around the chest ensures a more athletic definition of the chest. The endpoint of treatment (how much is removed and how much remains) is adjusted individually to ensure a smooth, masculine, and normal result.

Scar tissue formation is a natural consequence of the normal healing process. Patients often don’t develop harder masses that are felt and sometimes seen. In others, firmer chest areas with fullness most likely represent early scar tissue formation. Ignoring scar tissue can lead to firm masses that persist, contributing to something you can see and feel. This is why the Austin Gynecomastia Center recommends deep tissue massage with a rolling device, your hand, or a mechanical massage device. It is imperative to work the tissue to soften and eventually get absorbed by the body.

It is very easy for me to determine how much you have worked on your scar tissue. I have heard repeatedly that “I thought I was working it right,” when that was not the case. If you did work your tissue appropriately, you wouldn’t have the scar tissue to begin with! I typically have post-operative day one photos available to show a perfect result. However, suppose something appears that wasn’t there on day one. In that case, it’s either blood, seroma, anatomic variants, or scar tissue (although there is no such thing as perfection, I can actually do an excellent job of contouring my patients for the finest result). Timing is important, as well as managing scar tissue when it’s soft. Working out the tissue sooner than later is far more productive than waiting until it is rock hard. Like concrete, scar tissue hardens over time which changes treatment alternatives significantly.

Don’t overthink or fret about scar tissue. If it happens, it’s manageable. Timing is important. Working it properly is critical for successful resolution—this means time and effort daily until it’s smooth, soft, and flat. If you invest in your recovery, you will reap the rewards. Ignore your recovery, and you will be at the mercy of scar tissue which will only compromise your result. I want the best for you—do your job!