Gynecomastia surgery scars – how bad are they?

Nearly 27,000 men had surgery for gynecomastia in 2017. So though it’s not the most common plastic surgery, it’s still quite popular. And one of the biggest concerns I hear from my patients is about the scars. So that’s our topic today- I’m going to explain the different types of gynecomastia surgery scars, and why they differ. I’ll also explain why scars themselves vary in quality, and how to get the best gynecomastia surgery scar (or really any scar!) possible.

Goals of gynecomastia surgery

Since I’m focusing on scarring in this post, I don’t have space to talk about gynecomastia itself. But I do have a great informational PDF that you can download here. As a quick summary, the goal of gynecomastia surgery is to improve the contour of the chest in men. This may involve:

• liposuctioning excess fat
• excising glandular breast tissue
• removing excess skin

Some men have all three problems, some just one or two. From a scarring perspective, the shortest scar will be from removing excess fat because the incision just needs to be long enough to allow a liposuction cannula under the skin- so about 4mm wide (this is the size of a staple for your non-metric people). The longest scar will be from removing excess skin.

What affects scarring?

Gynecomastia surgery scars are subject to the same factors that affect any scar. In no particular order, these are:

How the wound is created:

A clean surgical wound is always going to heal best. Compare that to a dirty crush injury (one example I can think of is taking a spill on your motorcycle and having your leg slide along the pavement with the bike on top. Ouch.) In the second example not only is there dirt and bacteria in the wound, but the tissue is traumatized. This all leads to a worse scar.

How the wound is closed:

This is where I come in. Plastic surgeons are wound care experts. You thought we were just here for the cosmetic stuff, didn’t you? Nope- we are actually the doctors other doctors come to when they can’t get a wound to heal. Our training actually focuses on the best way to manage wounds, including how to get the best scarring. There are a lot of technical factors involved, including the type of suture used, how exactly the  suture is put in, and even the orientation of the original incision.

Post-surgery scar management:

Also very important, treating a gynecomastia surgery scar may involve scar massage, silicone gel or sheets, and even laser treatments.

Genetics:

Some people tend to form bad scars. These are the kind of scars that get thick and ropy, or raised up. Fighting genetics is tough, so if you scar badly, gynecomastia surgery scars are no exception. Now, a word of advice here- many people will show me scars on the center of their chest, a shoulder, or a knee as examples of bad scars. These areas are under tension and scar pretty badly for everyone. So look for a scar in an area that generally heals well – hands, arms, your stomach – to get an idea of how you tend to heal.

So just how bad are the scars from gynecomastia surgery?

The very best case scenario: You have a tiny 4mm scar and you heal well. The end result will look like you had a mole removed, if even that visible. I’ve had liposuction and I have trouble finding my liposuction scars after a year.

Compare this to the very worst case scenario: A long scar across the chest and you form a thick, raised scar. Let me reassure you this is very uncommon. Even with the longs scars from skin excision, the most likely end result is a flat, thin, light pink line.

How do you know if gynecomastia surgery is worth the scar?

Your first step is to see a Board-certified Plastic surgeon who can tell you what type of treatment you will need. This will tell you approximately how long of a scar you’re looking at. Then think about how you heal- are your scars flat and narrow, or are they raised up and thick? With this information you can ask yourself: how would you feel having the worst case scenario scar vs. just having gynecomastia tissue? That’s a decision only you can make, but I hope the information in this post can give you a little better idea of the factors involved.

And if you want to learn a little more about gynecomastia causes and treatment, check out my downloadable PDF.