Gynecomastia with Puffy Nipples – 2 Weeks After Surgery

Francis Jeon2026-08-17T23:06:25+09:00

Gynecomastia with Puffy Nipples – 2 Weeks After Surgery

A slim chest where the complaint was not size, but the areola standing proud.

GynecomastiaLiposuction with glandular excision13 days post-op

Concern: Grade 2 gynecomastia — puffy, protruding areolae on an otherwise slim chest
Procedure: Liposuction with glandular excision through a periareolar incision
Tissue excised: 42 g right, 40 g left
Photographs: Before surgery and 13 days after

You do not need a large chest to have gynecomastia. This patient was slim. What bothered him was a small, firm disc sitting directly behind each areola, pushing it forward so that it showed through a T-shirt. The chest itself was flat. The areola was not.

Why a slim chest can still look wrong

Glandular tissue sits immediately under the areola. When it enlarges it has nowhere to spread, so it lifts the areola into a dome and pushes the nipple out. On a heavier chest that dome is lost inside the general fullness. On a lean chest there is nothing to hide it, which is why a thin man can be more bothered by a small amount of gland than a heavier man is by a lot.

This is the pattern usually described as puffy nipples. It is not a separate condition — it is gynecomastia in which the gland is the whole of the problem.

Losing weight will not fix this. There is very little fat involved. The disc behind the areola is glandular tissue, and it stays exactly where it is no matter how lean you get.

Evita Clinic

Why liposuction alone would not have worked

Glandular tissue is dense and fibrous and will not pass through a liposuction cannula. In this case the excised specimens weighed 42 g on the right and 40 g on the left — not a large volume, but firm, and located precisely where it shows.

Suctioning the surrounding fat and leaving that disc behind would have made the problem more visible, not less: remove the soft tissue around a firm lump and the lump stands out further. The gland has to be excised, and excision requires an incision at the areolar border.

What the photographs show

Before surgery, each areola is domed and the nipple is carried forward. At 13 days the areolae sit flat against the chest wall. The periareolar sutures are still in place and there is yellow-green bruising across the chest — both expected at this stage.

The small mole on the upper abdomen appears in the same position in both photographs. It is the landmark the two images were aligned on.

These are 13-day photographs. They are not a settled result. Swelling is still present, the sutures are still in, and the scar at the areolar border has not begun to mature — that takes 6 to 12 months. What can be judged this early is the shape: the dome behind the areola is gone, and that part does not come back.

Gynecomastia can present as puffy areolae on an otherwise slim chest.
The tissue behind the areola is gland, not fat — weight loss does not remove it.
Liposuction alone can make a firm disc more obvious rather than less.
Excision means a scar at the lower areolar border, which fades over 6 to 12 months.
Thirteen days is early: shape can be judged, swelling and scar cannot.

About these images

Both sessions were photographed against the same backdrop, with the patient’s written consent. Identifying features are outside the frame; nothing has been painted over.

The post-operative session was shot considerably closer than the pre-operative one, so the frames have been scaled to match anatomy the operation does not move — the vertical distances between the nipple line, a mole on the upper abdomen, and the navel. Three such measures agreed to within 0.3%. Chest width was deliberately excluded from that calculation, because flattening the breast can spread the nipples slightly and it is the one measurement the surgery itself could bias.

Alignment was anchored on the navel, the same crop is applied to both panels, and brightness was matched using the backdrop and the upper chest. The bruised area was excluded from the colour calculation so that it was not corrected away.

Nothing has been stretched, slimmed, reshaped or retouched. Results vary depending on individual anatomy, healing response, lifestyle factors and postoperative care. These images are provided for informational purposes only and do not guarantee specific results.

Gynecomastia Visible Only from the Side – 2 Weeks After Surgery

Francis Jeon2026-08-15T22:28:13+09:00

Gynecomastia Visible Only from the Side – 2 Weeks After Surgery

A chest that reads as nearly normal head-on, and unmistakably abnormal in profile.

GynecomastiaLiposuction with glandular excision2 weeks post-op

Concern: Grade 2 gynecomastia, apparent in profile rather than head-on
Procedure: Liposuction with glandular excision through a periareolar incision
Tissue excised: 35 g on the left, with a comparable specimen on the right
Photographs: Before surgery and 15 days after

Gynecomastia is a problem of projection, and projection does not photograph from the front. Looking straight on, this chest is only slightly full and the nipples sit a little proud. Turn ninety degrees and there is a distinct cone of tissue with the nipple at its tip. Both photographs are of the same chest on the same morning.

Why the front view understates it

A frontal photograph flattens the chest into an outline. It shows width and it shows the areola, but it cannot show how far the tissue stands away from the ribs — and that distance is the whole complaint.

This is why patients with exactly this pattern are so often told they are imagining it. Friends and family look at them head-on, see a chest that is more or less flat, and say so. The patient, meanwhile, is looking down at themselves, or catching a side profile in a changing-room mirror, and seeing something quite different. They are both looking at the same chest from different angles, and only one of those angles carries the information.

If you are unsure whether what you have is gynecomastia, photograph yourself from the side with your arm down, not from the front. The side view is the one that answers the question.

Evita Clinic

What the photographs show

Before surgery

In profile, firm tissue lifts the lower chest into a rounded cone and carries the nipple forward and slightly downward. Head-on, the same chest shows only mild fullness with somewhat prominent areolae. The dominant tissue here is glandular, which is why it holds a defined shape rather than draping the way fat does.

15 days after surgery

The profile is flat: the cone is gone and the chest wall runs in a straight line from the collarbone down to the abdomen. The periareolar incisions are visible as dark crusted lines at the lower edge of each areola, still healing rather than yet scars. Bruising has largely cleared by this point.

Why liposuction alone would not have worked

Glandular tissue is dense and fibrous and will not pass through a liposuction cannula. Removing only the surrounding fat leaves the firm disc in place, and with the softer tissue around it gone, that disc often becomes more conspicuous rather than less. The gland has to be excised, and excision requires an incision.

We have set out that trade-off in more detail, along with what the first six weeks of recovery actually look like, in a separate case photographed at 8, 15 and 40 days.

The scar

The incision follows the lower border of the areola, where pigmented skin meets ordinary chest skin. That colour change disguises the line well, but the scar is permanent. At two weeks it is still a healing wound; scars of this kind continue to fade over roughly 6 to 12 months.

What this operation did not do

The abdomen is unchanged between the two photographs, and was never the target. Gynecomastia surgery corrects the chest. It is not a weight-loss operation and it does not contour the trunk.

Two weeks is early. These are the earliest photographs we would publish, and they are not a settled result. Swelling is still present in the operated area at this stage, the incisions are healing wounds rather than mature scars, and the final contour will continue to refine over the following weeks and months. An early photograph misrepresents this operation in both directions — the chest is still slightly swollen, and the scar looks angrier than it will.

Gynecomastia is a problem of projection, which a frontal photograph cannot show.
A chest can look nearly flat head-on and still carry a clear glandular cone in profile.
If you are assessing yourself, photograph from the side with the arm down.
Glandular tissue cannot be suctioned; it has to be excised, and that leaves a permanent areolar-border scar.
These photographs are at 15 days and are not a settled result.

About these images

The two sessions were photographed at different camera distances. The post-operative frames have been scaled so that the shoulder and collarbone silhouette matches the pre-operative frame — a region this operation does not alter — with the alignment solved by computer rather than by eye, and the same crop applied to both panels. Brightness and colour were matched between sessions using the backdrop and the shoulder skin as references.

Nothing has been stretched, slimmed, reshaped or retouched. Identifying features have been cropped out of frame rather than painted over.

Results vary depending on individual anatomy, healing response, lifestyle factors and postoperative care. These images are provided for informational purposes only and do not guarantee specific results.

Gynecomastia Surgery (Liposuction with Glandular Excision) – 6 Weeks After Surgery

Francis Jeon2026-08-15T21:34:40+09:00

Gynecomastia Surgery (Liposuction with Glandular Excision) – 6 Weeks After Surgery

Grade 2 gynecomastia, photographed before surgery and at 8, 15 and 40 days — what changes, and when.

GynecomastiaLiposuction with glandular excision6 weeks post-op

Concern: Grade 2 gynecomastia — firm glandular tissue with nipple protrusion
Procedure: Liposuction with glandular excision through a periareolar incision
Tissue excised: 59 g right, 84 g left, in addition to aspirated fat
Photographs: Before surgery, 8, 15 and 40 days after

The shape is corrected at surgery — not gradually over the following weeks. The chest is already flat in the 8-day photograph. What changes between 8 days and 6 weeks is the bruising, the swelling and the wound. Recovery is about the skin settling down, not about the contour slowly arriving.

This distinction matters, because the first two weeks are when patients worry most. At 8 days the chest is covered in bruising and the areolar wounds are still closed with sutures. It looks alarming. The underlying shape at that moment is already the shape that will be there at six weeks.

What the photographs show

Before surgery

Firm tissue behind each nipple lifted the chest into a distinct mound, with the nipple itself pushed forward. The side view shows this most clearly: the breast projects in a cone with the nipple at its apex. This is Grade 2 gynecomastia — moderate enlargement without significant skin excess.

8 days — the bruising is at its worst

The contour is flat. Everything else about this photograph looks worse than it will at any later point: yellow-green bruising covers the chest and tracks down toward the upper abdomen, and the periareolar incisions are closed with visible sutures.

This is a normal course, not a complication. Bruising after gynecomastia surgery typically peaks in the first week to ten days and then drains downward under gravity, which is why it appears lower on the chest as it fades.

15 days — bruising largely gone

Two weeks on, the bruising has mostly cleared. The wounds at the areolar border are still crusted and are not yet scars — they are healing skin. The side view at this stage shows the projection has gone: the chest profile is flat where it previously curved forward.

40 days — settled

Swelling has resolved and the incision line has begun to blend into the lower border of the areola. Small dressings are still on the nipples in this photograph.

Why liposuction alone would not have worked

Gynecomastia is not simply fat on the chest. In this case the excised specimens weighed 59 g on the right and 84 g on the left, and were dense fibrous glandular tissue mixed with fat.

Liposuction removes fat. It does not remove glandular tissue, which is far too firm to pass through a cannula. Treating a chest like this one with liposuction alone would take out the surrounding fat and leave the firm disc behind — and with the softer tissue around it gone, that disc frequently becomes more obvious, not less.

Liposuction thins the chest. Excision is what removes the gland. Grade 2 gynecomastia needs both, which is why the incision at the areolar border is part of the operation rather than an optional extra.

Evita Clinic

The scar

The incision runs along the lower border of the areola, where the pigmented skin meets ordinary chest skin. That border hides a scar well, because the colour change along the line disguises it.

It is still a permanent scar. In the 8-day photograph the sutures are in place and the line is obvious; by 40 days it has begun to settle into the areolar edge. Scars of this kind continue to fade over roughly 6 to 12 months.

Show the incision at 8 days (clinical close-up)

Periareolar incision at 8 days after gynecomastia surgery, sutures in place at the lower areolar border – Evita Clinic Seoul — Eight days after surgery. The incision follows the lower edge of the areola; sutures and antiseptic staining are still present, and the surrounding bruising is at this stage still resolving.

What this operation did not do

This was chest surgery. The abdomen is unchanged across all four photographs, and it was never the target of the operation. Gynecomastia surgery corrects the chest; it is not a weight-loss procedure and it does not contour the trunk.

Patients whose main concern is generalised body fat rather than glandular tissue are usually better served by a different conversation, and often by no operation at all.

These are 40-day photographs, not a final result. The scar is early in its maturation and will continue to fade for 6 to 12 months. The faint horizontal line crossing the chest in the 40-day image is a pressure mark from the compression garment, not a scar or an incision — it settles within hours of the garment coming off.

The chest contour is corrected at surgery and is already flat at 8 days.
What improves over the following weeks is bruising, swelling and wound healing — not the shape.
Bruising peaks in the first week to ten days; this is expected, not a complication.
Grade 2 gynecomastia needs excision as well as liposuction, because glandular tissue cannot be suctioned.
The scar sits at the lower areolar border and fades over 6 to 12 months.

About these images

The four sessions were photographed at different camera distances — the 8-day session was shot roughly 13% closer than the pre-operative one, and the 40-day session roughly 13% further away. Left uncorrected, that alone would make the chest appear to change size between panels.

Each post-operative frame has therefore been scaled so that the shoulders and collarbones match the pre-operative frame — a region this operation does not alter. The alignment was solved by computer rather than by eye, and the same crop is applied to every panel. Brightness and colour were matched between sessions using the backdrop and the shoulder skin as references; the bruising was deliberately excluded from that calculation so that it was not corrected away.

Nothing has been stretched, slimmed, reshaped or retouched. Identifying features have been cropped out of frame rather than painted over.

Results vary depending on individual anatomy, healing response, lifestyle factors and postoperative care. These images are provided for informational purposes only and do not guarantee specific results.

FTM Top Surgery – Free Nipple Graft Healing at 13 Days

Francis Jeon2026-08-15T07:14:29+09:00

FTM Top Surgery – Free Nipple Graft Healing at 13 Days

What the dark crust over a nipple graft is, and what an early photograph can and cannot tell you.

TOP SurgeryDouble incision with free nipple graft13 days post-op

Procedure: Double incision mastectomy with free nipple grafting
Incision: Horizontal, along the lower chest
Photographs: Before surgery and 13 days after
Stage shown: Grafts still crusted; crusts had not yet separated

What the dark crust is

In a double incision with free nipple grafting, the nipple is removed, resized and put back as a graft. A graft arrives with no blood supply of its own and has to take one up from the tissue underneath it.

While that is happening the surface of the graft is covered by a dark crust. At around two weeks that crust looks its worst — almost black, firm, with the sutures still in place. Its presence at this stage is the expected course, not a complication.

Almost every patient who searches for photographs at this stage is frightened by what they see. The crust is the part of the graft that was never going to survive; the graft is healing underneath it.

Evita Clinic

What happens next

The crust usually separates on its own at around two to three weeks. It should not be picked off. Underneath, the pigment appears gradually and continues to settle in colour and texture for months afterwards.

Partial loss of graft pigment is possible and is a recognised outcome of free nipple grafting. It cannot be predicted from a photograph at this stage, in either direction.

What this photograph can and cannot tell you

It can show the chest contour at thirteen days, the position and line of the incision, and what the grafts genuinely look like at this point in recovery.

It cannot show how the grafts finally looked. These photographs were taken before the crusts had separated, so the final appearance of the nipples is not visible here and is not claimed.

For a chest photographed after the crusts had separated, see our double incision case at three weeks. That is a different patient; healing timelines vary between individuals.

A free nipple graft has no blood supply when it is placed and must take one up.
The dark crust at around two weeks is expected, not a sign of failure.
The crust separates on its own at roughly two to three weeks and should not be picked.
Pigment settles over months; an early photograph cannot predict the final appearance.

About these images

Both frames are cropped identically and shown at the same scale. Scale was verified by measuring shoulder span, which this operation does not change, at five separate levels; the frames are aligned on the sternal notch. Nothing has been stretched, reshaped or retouched.

This patient is extensively tattooed, so the crop is drawn tightly to keep identifying ink out of frame rather than painting over it. Only the front view is published.

Results vary depending on individual anatomy, healing response, lifestyle factors and postoperative care. These images are provided for informational purposes only and do not guarantee specific results.

Brazilian Butt Lift (Fat Grafting) – 12 Days After Surgery

Francis Jeon2026-08-14T04:09:49+09:00

Brazilian Butt Lift (Fat Grafting) – 12 Days After Surgery

Gluteal augmentation using the patient’s own fat, photographed before surgery and at 12 days.

Fat GraftingGluteal Augmentation12 days post-op

Concern: Flat gluteal projection, poor waist-to-hip definition
Procedure: Autologous fat grafting to the buttocks (Brazilian butt lift)
Fat source: Harvested by liposuction from the patient’s own donor areas
Photographs: Before surgery and 12 days after

How the operation works

A Brazilian butt lift adds no implant. Fat is harvested by liposuction from areas where it is not wanted, processed, and then grafted into the buttock in fine layers so that it can pick up a blood supply.

Because the graft has to survive on that new blood supply, not all of it does. The proportion that takes is what determines the final shape, and it is not known on the day of surgery.

What the photographs show at 12 days

Projection is increased and the upper and lateral buttock is fuller, which lifts the waist-to-hip transition. Small entry points from the grafting cannulas are visible at the infragluteal folds, and there is bruising from both the donor areas and the recipient site.

This photograph shows more volume than the final result. At 12 days the swelling has not settled and none of the graft has been resorbed yet. Over the months that follow, part of the transferred fat is reabsorbed and the buttock becomes smaller than it appears here.

This is the opposite of most body procedures, where an early photograph understates the result. With fat grafting an early photograph overstates it, which is why the timing is stated plainly rather than left out.

The honest way to read a 12-day fat grafting photograph is as evidence that volume was placed and is surviving so far — not as the shape the patient will keep.

Evita Clinic

A BBL uses the patient’s own fat, not an implant.
Only part of the transferred fat survives; the surviving proportion sets the final shape.
Volume at 12 days is greater than the volume that settles months later.
Bruising at the donor and recipient areas is expected at this stage.

About these images

Both frames are cropped identically and shown at the same scale. Scale was verified against the thigh silhouette at a level that is neither the graft site nor a donor site, and the frames are aligned on the sacrum, which a fat graft does not move.

Nothing has been stretched, reshaped or retouched. The crop excludes identifying features rather than painting over them, and the disposable underwear at the centre of each frame is deliberately blurred; the gluteal contours are untouched.

Only the back view is published. The front and oblique frames carried an identifying feature that a crop could not remove, and the lateral frames from the two sessions did not match in orientation.

Results vary depending on individual anatomy, healing response, lifestyle factors and postoperative care. These images are provided for informational purposes only and do not guarantee specific results.

Tummy Tuck After Major Weight Loss – 3 Weeks After Surgery

Francis Jeon2026-08-12T22:09:47+09:00

Tummy Tuck After Major Weight Loss – 3 Weeks After Surgery

Redundant lower abdominal skin removed by excision, photographed before surgery and at 19 days.

Body LiftAbdominoplasty3 weeks post-op

Concern: Redundant lower abdominal skin after major weight loss
Procedure: Abdominoplasty with umbilical transposition
Incision: Low transverse, hip to hip, placed below the underwear line
Photographs: Before surgery and 19 days after

The problem was skin, not fat

After major weight loss this patient was left with an apron of redundant lower abdominal skin, deeply stretch-marked, hanging past the pubis. The tissue that remained was loose skin, not fat.

Liposuction does not solve this. Where the skin has already lost its elasticity, removing the fat underneath leaves the envelope behind and often makes the looseness more obvious. Flattening the abdomen means excising skin, and excising skin means a permanent scar.

The scar is the trade-off of this operation. It runs from hip to hip and it is permanent. It can be placed low enough to sit under underwear, but it cannot be avoided.

Evita Clinic

What was done

Abdominoplasty with excision of the redundant lower abdominal skin and transposition of the umbilicus to its new position. The incision was placed as low as possible so that it sits below the underwear line. Brachioplasty was performed at the same operation; those photographs are not published here.

This is a different problem from a lipoabdominoplasty, where circumferential fat is treated alongside the skin. Here the fat was not the issue.

What the photographs show at 19 days

The overhanging apron is gone and the abdominal contour is flat. The low hip-to-hip scar is visible, and the umbilicus is healing in its new position, still red and crusted.

Yellow crusting can be seen at both lateral ends of the incision. Those are the points of greatest tension across the closure, this is a common finding at three weeks, and it was under review at the time of the photograph.

Three weeks is not the finished result. The scar will stay red and firm for several months before it flattens and fades, and maturation continues beyond a year. Residual swelling means the abdomen still looks thicker than it eventually will. An early photograph understates the result and overstates the scar at the same time.

Loose abdominal skin after weight loss is corrected by excision, not by liposuction.
The scar runs hip to hip and is permanent; it is placed low so underwear covers it.
The umbilicus is repositioned as part of the operation.
Swelling and scar redness continue to settle for months after these photographs.

About these images

Both frames are cropped identically and shown at the same scale. Scale was verified against the thigh silhouette — tissue this operation did not touch — and the two sessions matched to within 1.5%. Nothing has been stretched, reshaped or retouched.

The crop excludes the face and other identifying features rather than painting over them. The underwear band at the foot of each frame is deliberately blurred; the abdomen and the scar are untouched.

Only the front view is published. The oblique and lateral files from this visit had been cropped before archiving, which left no way to verify their scale, so they were excluded rather than shown unverified.

Results vary depending on individual anatomy, healing response, lifestyle factors and postoperative care. These images are provided for informational purposes only and do not guarantee specific results.

Arm Lift (Brachioplasty) – 5 Weeks After Surgery

Francis Jeon2026-08-09T18:49:09+09:00

Arm Lift (Brachioplasty) – 5 Weeks After Surgery

Redundant upper-arm skin corrected by excision, photographed before surgery, at 14 days and at 33 days.

Body LiftBrachioplasty5 weeks post-op

Concern: Redundant upper-arm skin, worse on abduction
Procedure: Brachioplasty (arm lift) with fusiform skin excision
Incision: Along the inner upper arm, from the axilla toward the elbow
Photographs: Before surgery, 14 days and 33 days after

Why excision, and not liposuction

This patient’s problem was loose skin, not excess fat. With the arms raised, the lower border of each upper arm fell away in a distinct curve.

Liposuction cannot fix that. Where skin has already lost its elasticity, taking fat out from underneath leaves the skin behind and often makes the looseness more obvious. Tightening the arm means removing skin, and removing skin means a permanent scar.

The scar is the trade-off of this operation. It runs the length of the inner upper arm, and it is permanent. A patient who is not willing to accept that scar is not a candidate for brachioplasty.

Evita Clinic

The surgical plan

The marking shows the fusiform strip of skin to be excised, running from the armpit along the inner upper arm. Its width is judged with the arm in different positions so that the closure is neither loose nor under tension.

The short cross lines with paired numbers are alignment marks. After the strip is removed, the upper and lower wound edges are not the same length. Sewing matching numbered points to each other distributes that difference evenly along the arm, instead of letting it bunch up at one end.

What happens week by week

Up to 2 weeks — swelling is still present

The middle photograph was taken at 14 days. Swelling at this stage is expected and the arm looks fuller than it eventually will. Suture lines are visible in the armpit, with some residual redness and leftover surgical marking on the skin.

2 to 4 weeks — swelling subsides

Through this period the swelling comes down in earnest, and the contour created at surgery starts to show.

From about 4 weeks — the shape settles

By roughly four weeks the shape is reasonably stable. This is the point where care shifts from managing swelling to managing the scar, which is still red and firm in its early maturation phase.

Through 4 to 5 months — skin retraction continues

At five weeks some swelling and localised looseness remain, and that is a normal part of the course. Skin retraction continues to tighten the contour through roughly four to five months. The scar goes on fading for 6 to 12 months beyond that.

These are five-week photographs, not a final result. Neither the contour nor the scar has finished changing at this point. Judging brachioplasty from an early photograph will misrepresent it in both directions — the swelling makes the arm look fuller than it will be, and the scar looks angrier than it will be.

Loose upper-arm skin is corrected by excision, not by liposuction.
The scar runs the length of the inner upper arm and is permanent.
Swelling persists for about two weeks, then subsides; the shape settles from around four weeks.
Skin retraction keeps improving the contour to four or five months; the scar fades for 6 to 12 months.

About these images

The three sessions were photographed at slightly different camera distances. To make them comparable, the post-operative frames have been scaled so that shoulder width matches the pre-operative frame — a dimension this operation does not change. Nothing has been stretched, reshaped or retouched, and the same crop is applied to every frame.

The central chest is deliberately blurred so that attention stays on the arms. The arms themselves are untouched. Identifying features have been cropped out of frame rather than painted over.

Results vary depending on individual anatomy, healing response, lifestyle factors and postoperative care. These images are provided for informational purposes only and do not guarantee specific results.

FTM Top Surgery (Double Incision with Free Nipple Graft) – 3 Weeks After Surgery

Francis Jeon2026-08-09T06:10:56+09:00

Gender-affirming chest surgery

FTM Top Surgery (Double Incision with Free Nipple Graft) – 3 Weeks After Surgery

A large, ptotic chest where double incision was the only technique that could produce a flat result. 659 g removed on the right, 612 g on the left.

Before: 11 June 2026After: 3 July 2026 · day 22Surgeon: Dr. Francis Jeon

FTM top surgery before and after, front view, 3 weeks post-op – Evita Clinic Seoul — Front view. Before surgery, and 22 days afterwards.

Why double incision here. Keyhole and periareolar techniques remove the gland through a small incision and rely on the skin retracting on its own. This patient had too much volume and too much sagging for that to work: those methods would have left loose skin and a poor contour. Double incision removes the excess skin as well as the gland, and the nipple is repositioned as a free graft.

Procedure: Double incision mastectomy with free nipple graft
Tissue removed: 659 g right · 612 g left
Photographs: Before surgery, and 22 days after surgery
Views shown: Front, oblique and lateral

Why this chest needed the longer scar

The trade-off in top surgery is scar length against how flat the result can be. A keyhole incision hides almost completely, but it can only work when the volume is modest and the skin is elastic enough to shrink back on its own.

Neither was true here. Once the gland is removed from a chest this size, the skin that held it does not retract far enough, and what remains sits as a fold above the crease. Double incision accepts a horizontal scar across each side of the chest in exchange for removing that skin directly, which is what makes a genuinely flat contour possible.

The nipple cannot stay attached to its blood supply when the skin around it is removed, so it is taken as a graft and replaced at the correct height and size for a male chest.

FTM top surgery before and after, oblique view, 3 weeks post-op – Evita Clinic Seoul — Oblique view. The chest wall contour is what this angle shows best.

What three weeks looks like

These photographs were taken before surgery and 22 days after surgery.

Three weeks is early, but it is far enough along to show the shape the operation produced. The chest is flat in profile, and the crease that carried the breast has gone. Swelling has largely settled compared with the first fortnight, though the tissue is still firm.

FTM top surgery before and after, side view, 3 weeks post-op – Evita Clinic Seoul — Lateral view. The projection present before surgery is gone.

The nipple grafts at three weeks

The dark crust over each nipple-areola complex is the expected appearance of a free graft at this stage, not a sign that the graft has failed. Over the following two to three months the crust separates on its own, new pink tissue forms underneath, and the colour and texture continue to settle for some time after that.

Grafted nipples lose sensation. Some sensitivity may return over the following year, but it should not be expected.

Scarring

The scars sit along the lower chest, where the pectoral border falls. They are red and firm at this stage, then flatten and fade gradually. Scar maturation continues for a year or more, so nothing about the final scar can be judged from a three-week photograph.

Patients are asked to use silicone tape or scar gel once the wounds have closed, and to keep the scars out of direct sun during the first year.

This is an early photograph, not a final result. At three weeks the scars are red, the grafts are still crusted, and the tissue is still firm. The contour continues to refine for several months, and the scars for considerably longer.

About these images

Both frames in each pair are shown at the same scale and cropped identically. The post-operative session was photographed from slightly further back, so the after images were enlarged to match — measured from the shoulders, arms and waist, which this operation does not change. Nothing about the chest has been rescaled, slimmed or retouched.

A tattoo has been masked in one frame so that the patient cannot be identified. That is the only alteration to the photographs.

Results vary depending on individual anatomy, skin elasticity, healing response and postoperative care. These images are provided for informational purposes only and do not guarantee specific results.

Related cases

Double incision with free nipple graft – 2 weeks after surgery, in a patient with considerably less volume, where a keyhole technique could also have been considered.
Keyhole technique – 2 weeks after surgery, showing what the minimal-incision approach looks like when the chest is small enough for it.

Compare FTM top surgery techniques
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FTM Top Surgery (Minimal Incision) – 1 Week After Surgery

Francis Jeon2026-08-09T04:53:46+09:00

FTM Top Surgery (Keyhole Technique) – 1 Week After Surgery

Case description

This patient had moderate breast volume with good skin quality and no significant sagging. Where the skin can be expected to retract on its own, the gland can be removed through a small incision at the lower border of the areola, and the nipple stays where it is on its own blood supply. No free nipple graft is needed, and there is no incision across the chest.

We removed 195 g of glandular tissue on the right side and 143 g on the left, with liposuction to blend the edges into the chest wall.

The trade-off is honest: keyhole leaves by far the least scarring, but it relies on the skin tightening by itself. It is the right operation when the volume is moderate and the skin is elastic, and the wrong one when the chest is large or the skin already hangs — in that situation a double incision gives the flatter, more definitive result.

What one week looks like

These photographs were taken before surgery and 7 days after surgery.

One week is early. The dark crust over each areola is the incision healing and is expected at this stage; it separates on its own over the following weeks. The yellow-brown discolouration across the chest is bruising and surgical skin preparation, not a burn, and it fades. Swelling has not settled, so the chest still looks fuller and firmer than it will.

The change in chest projection is already clear from the front and in profile, but this is an early photograph, not a final one.

The same technique at two weeks, in a different patient: FTM top surgery (keyhole technique) – 2 weeks after surgery. Seeing the two side by side gives a more realistic sense of how quickly the crusting and bruising settle.

Scarring

The incision sits along the lower edge of the areola, where the colour change between areola and chest skin hides it. It is red and firm at first, then softens and fades. Scar maturation continues for a year or more, and the final appearance cannot be judged from a one-week photograph.

What changes from here

Swelling settles gradually over the first few months, and the chest contour keeps refining as it does. Patients wear a compression vest as directed, and scar care begins once the wound has closed. Chest and shoulder exercise is resumed in stages rather than all at once.

About these images

Both frames are shown at the same scale and cropped identically. Because the post-operative photographs were taken from further back, the after images were enlarged to match the before images — measured from the shoulders and the navel, which this operation does not change. Nothing has been reshaped, slimmed or retouched.

Results vary depending on individual anatomy, skin elasticity, healing response and postoperative care. These images are provided for informational purposes only and do not guarantee specific results.

Lipoabdominoplasty (Tummy Tuck with 360° Liposuction) – 2 Weeks After Surgery

Francis Jeon2026-08-09T06:23:41+09:00

Lipoabdominoplasty (Tummy Tuck with 360° Liposuction) – 2 Weeks After Surgery

Case description

This patient came to us with loose lower abdominal skin and circumferential fat around the waist and flanks.

Liposuction alone would not have solved his problem. Where skin is already hanging, removing the fat underneath leaves the skin behind — and can make the looseness more obvious. Meaningful tightening requires the skin to be excised, and excision means a permanent scar across the lower abdomen. This is the central trade-off, and he accepted it.

We performed a lipoabdominoplasty: anterior and flank liposuction combined with a full abdominoplasty, including umbilical transposition. Approximately 1,370 g of skin and fat was excised. That figure is the resected tissue alone; the liposuction aspirate is separate from it.

What these photographs show

The photographs were taken before surgery and 14 days after surgery.

At two weeks, the result still looks like two weeks. The scar is red and raised, swelling has not settled, and the abdominal wall is still firm to the touch. The waistline change is already visible from the front and in profile, but this is an early photograph, not a final one.

Scar maturation

The scar is placed low so it sits below the underwear line. It will stay red and firm for the first few months, then flatten and fade gradually. Scar maturation continues for a year or more, and the final appearance cannot be judged from a two-week photograph.

About these images

Both frames are shown at the same scale and cropped identically, anchored on a fixed anatomical landmark. Nothing has been rescaled, stretched or reshaped between the before and after photographs.

Results vary depending on individual anatomy, healing response, lifestyle factors and postoperative care. These images are provided for informational purposes only and do not guarantee specific results.