09 Nov Crater Complications Post-Gynecomastia Surgery: The Most Dreaded Complication Post Gyno Surgery

Gynecomastia surgery is often a transformative experience for those seeking to address the physical and emotional challenges associated with the condition. However, in some cases, individuals may encounter complications, with one of the most dreaded being the development of craters or depressions post-surgery. In this blog, we’ll explore the intricacies of crater complications and delve into two promising treatment options: massage and fat grafting.

Craters, in the context of gynecomastia surgery, refer to depressions or irregularities in the chest area. These can occur when there is an excess of fat and gland removal or uneven distribution of tissue following the surgical procedure. A crater post gyneceomastia surgery is often present immediately after surgery. Occasionally, if the crater is mild, the deformity will only present itself once swelling subsides.

There are three main components of improving the appearance of a crater: Time, Massage, and Fat Grafting.

Over the months following surgery, the body will even out some mild irregularities over time. This will usually plateau at the one year mark.

Massaging the surrounding area can notably improve the crater. Massaging a post surgical area twice a day for ten minutes for a minimum of three months has been scientifically proven to soften scar tissue and improve post surgical irregularities.

Fat grafting is a surgical technique that has shown the most promise in correcting crater complications. The procedure involves harvesting fat from one area of the body, purifying it, and then strategically injecting it into the areas with depressions to achieve a more even and natural-looking contour. Fat grafting is the go to method to improve a crater deformity. It is usually an improvement but not a perfect fix as fat graft survival is variable. Fat cells that are grafted rely on the tissues around them to get blood supply. A secondary option is a fat flap. A flap retains it’s own intrinsic blood supply so the take is much less variable and therefore has a more predictable result. The issue with fixing a crater with a fat flap versus a fat graft is where to get the fat flap from. The fat flaps used are considered local pedicled flaps. This means the fat has to be adjacent to the crater as the base of the flap has to remain intact for the blood supply while the rest of the flap needs to be mobilized into the crater.The problem is that it is very rare to have enough adjacent fat next to the crater post gyno surgery that it can fill the crater with a fat flap. For fat grafting, you can simply lipo anywhere on the body to harvest the fat.

While time, massage and fat grafting can improve a crater deformity, it is rare that the issue ver fully resolves.

This is why it is essential that the Gyno surgeon has experience and is aware of this complication and how to avoid it intraoperatively. To date, at Toronto Gynecomastia Center, we have not had a single crater deformity. While we have had a small number of patients with residual fullness, this is easy to address with a short follow up procedure to remove the remaining extra tissue.