Revision of Crater Deformity Complication after Canada Gynecomastia Surgery.
22 year old male had gynecomastia surgery in Canada 3 years ago. He did not like the resultant "sunken nipples crater" deformity. His original problem was Puffy Nipple Gynecomastia. Right after surgery, the contour looked fine. As the swelling resolved, he noticed that his nipples were "flat, concave wrinkled and pitted." He also complained about the "very visible scar (as the incision wasn't on the edge)" of the areola and scar tissues. Prior surgery was a combination of liposuction followed by excision. The deformity was a Bursa Crater Deformity with an obvious depigmented scar inside the areola / nipple leaving a bizarre crescent outside. The deformity looked worse when lying on his back, warm rooms, movement, and flexing. The deformity improved in cold rooms and while standing. He traveled from Canada for Dr. Bermant's Revision Gynecomastia Surgery.
Movie Revision Canadian Crater Defect
Flash Video 
11.5 MB 2 minutes 42 seconds. Watch how this subtle crater deformity moves after Canada Gynecomastia Surgery . Then at only 2 weeks, see how Dr. Bermant's sculpture improved this bursa crater deformity. Watch how tissues move and flex before and after revision surgery.
QuickTime Movie Before After Revision 
(same movie).
Movie Bursa Crater Defined
Flash Video 2.1 MB 25 seconds demonstrating Bursa Crater Wall
Learn more about the Bursa Crater Deformity variation of Crater Deformity Complication after Gynecomastia surgery.
QuickTime Movie Showing Exam Crater Defect (same movie).
Chest Muscles Relaxed, Flexing, & Arms Up Overhead
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Photos Arms Up -Canada Crater Complication Before and 2 weeks after Revision Surgery |
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Photos - Canada Crater Complication Before and 2 weeks after Revision Surgery |
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Photos Relaxed - Crater Complication Before and 2 weeks after Revision Surgery from Canada |
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Photos Flexed - Canada Crater Complication Before and 2 weeks after Revision Surgery |
Move your cursor over the smaller images to compare relaxed to flexing, before to after surgery. Slide your cursor between pictures to see changes with motion and surgery. It is in the comparison between the photographs that you can see the problems of this Crater Deformity Complication and the changes with revision surgery.
Oblique Pictures Before and After Revision Surgery for Bursa Crater Complication.
Before and 2 Weeks after Revision Surgery for Bursa Crater Deformity from Gynecomastia Surgery Done in Canada.
Side Pictures Before and After Crater Revision Surgery.
Before and 2 Weeks after Revision Surgery for Bursa Crater Deformity from Canadian Gynecomastia Surgery..
Posterior Oblique Pictures Before and After Revision Bursa Crater
Before and 2 Weeks after Revision Surgery for Bursa Crater Deformity from Gynecomastia Surgery Done in Canada.
Healing Swelling & Bruising After Revision Crater Defect.
| Photo Bursa Crater Deformity | |
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Photo Only 1 day after revision surgery. |
| Photo Only 1 week after surgery. |  |
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Photo 2 weeks after revision. |
Notice that this patient's extensive surgery still was typical of the minimal swelling and bruising of Dr. Bermant's techniques.
Picture before revision, the prior surgery scar was inside the areola leaving a crescent of pigmentation separated from the remaining nipple. Photo 2 weeks after revision paper tape reinforces sculpture.
Gland & Scars Removed During Revision
Pictures during surgery of gland and scar tissue removed from each side. Despite this being a Crater defect, there was still residual gland (fibrotic phase) left by the other surgeon. In the chest, the masses were much flatter. On removal, they became thicker with a smaller diameter. The separate crescent of skin was the outer piece of areola outside of the prior scar. Dr. Bermant moved the new scar to the edge of the areola.
This patient had an unusual variation of a Crater Complication Scar. The skin was not adherent to the deepest aspects of the crater but floated attached to a loose filmy layer just like what the loose attachments of the skin found on the elbow or knee. This loose connection explains why the contour problem varied on position and movement and why it was hard to show on photographs. Flexing and arm raising photos showed the contour problem to a degree. Movies show the crater somewhat better. In person the problem was obvious. On examination gentle pressure collapsed the nipple down to the base of the crater. This video also shows the walls of this defect and how there was missing tissue. A normal nipple areola should have support that has approximately the same consistency of surrounding tissues. In addition the patient did not like the scar from the Canadian surgery inside of the areola. Dr. Bermant, moved this scar to the edge of the areola during his revision surgery.
Revise Canadian Crater Complication Deformity with Loose Attachments.
Right 3 x 2 x 1.4 cm and Left 3 2.5 x 2 cm fibrotic phase gynecomastia pathology specimens. Fat suctioned negligible all remaining tissue used to rebuild crater defect.
6 feet tall weighing 150 pounds
Location Surgery: Bermant Plastic Surgery Center (Office Operating Room)
Anesthesia: Tumescent Local with Sedation
Method: Dynamic technique, revision gynecomastia contouring with, crater deformity reconstruction with, fat flap sculpture, microcannula liposuction, and revision areola scars.
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Revision Gynecomastia SurgeryGynecomastia |
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