This video shows a crater deformity also called a saucer deformity. This video is from Dr Miguel Delgado’s who is a plastic surgeon in San Francisco. Once you get this deformity you will need revision plastic surgery, that can be quite difficult as the nipple is then stuck down. It occurs when too much gland tissue has been removed and where the edges of the gland tissue have not been appropriately feathered in. I have seen quite a few men that have had gynaecomastia operations done by other plastic surgeons or cosmetic surgeons without using liposuction, which has caused this deformity. If you are seeing a plastic or cosmetic surgeon it is really important that you ask them about their technique and also for them to show you lots of before and after photos. In my opinion it is essential to use liposuction to avoid this problem.
Ideally, the liposuction should be done with a VASER liposculpture machine. The Vaser liposculpture machine melts the fat and can also remove quite a bit of the breast gland so that when you make the incision to remove the gland it is nicely feathered in.
Trying to fix these deformities can be quite difficult and depend on a lot of factors. Sometimes there is a depression there but the gland is not stuck down or tethered. I find that in these situations it can be quite easy to just do additional Vaser Liposculpture around the gland, and this will just complete the result. If the areola is really stuck down, then a small amount of fat injection, in addition to releasing the areola, and performing liposuction around the area would usually create a good result.
The other thing I tend to do, to give you an even better result, is to do a lot of liposuction on the side of the chest, because that defines the muscle edge. If you are a bodybuilder, then obviously you have a lot of muscle already, with very minimal fat, so we just have to do a tiny bit of lipo around the gland just to feather the gland in, make sure that there isn’t depressions, and then cut out the gland from there.
A manly chest is considered to look its best with defined pec muscles, and that’s what bodybuilders try to do, they try to increase their pec muscles. This can also be achieved with pec implants. What I do during surgery is to define the muscle edge. I achieve this by doing aggressive liposuction on the side of the chest wall and underneath the muscle. You really want to make sure that the muscle is nice and bulging in the middle, and that there is no puffy gland on the nipple areola complex. What you want to do is to show-off the pec muscle. The key thing is to understand how a male chest looks, it is not the same as doing surgery in women. I have a lot of patients that come in that obviously have a little bit of fat on top of the muscle. You don’t want to remove everything there, because that’s just going to make you look flat with no definition. It’s all about defining the pectoralis major muscle and making it look like you’ve really got the bodybuilding physique up top.