Swollen Areolas After Liposuction and Nipple Reduction

Question

I am a male who recently had a nipple reduction with liposuction. The doctor did not provide any compression and 5 weeks later, I still have swollen areolas and I look worse than before the surgery. What can I do?

	This is really bothering me. I started using a compression vest 4 days after the surgery. Should I continue to wear the vest or is it pointless at this point? I am concerned the streched areolas won't return to their original shape.

Jed H. Horowitz, MD, FACS · Answer

Thank you for your question.After #gynecomastia #surgery, #bruising and #swelling are normal and usually increase slightly
after the removal of any tape or foam. The bruising will decrease over 3-4
weeks, but may last as long as 6 weeks. The majority of the swelling will be
gone within the first 3-4 weeks. However it may take 6-9 weeks to disappear
completely. The compression garment helps reduce the swelling, and the longer
it is worn, the more quickly you will heal.If you are concerned, please contact your #BoardCertified #PlasticSurgeon for an in-person consultation.

Tim Neavin, MD · Answer

...Will continue to heal.  Compression probably won't make a difference at this point.  The big differences will be made with your close follow up with your doctor to makes sure things are healing well and that there isn't any type of infection, serum, or blood collection impairing the process.

Larry S. Nichter, MD, MS, FACS · Answer

Swelling is expected after every procedure. Every plastic surgeon has their individual routine following gynecomastia surgery. Not wearing a compression garment may not make any difference in the long run but will shorten the period of swelling in my experience. This is what I tell my patients: COMPRESSION GARMENT: Wear a compression garment after surgery for the next few weeks. The extra pressure this garment provides helps reduce swelling and discomfort. You should not remove this garment at all until the second or third day after surgery. After that, feel free to remove the garment temporarily for showering or laundering.  We want you to have circumferential pressure for 4-6 weeks, but you may switch to an exercise compression garment when advised.SHOWERING: You may shower three days after surgery.TAPING: The doctor may decide to cover your incisions with elastic tape or adhesive foam. On the third or fourth day after surgery, you may peel these off in the shower or bath. This is easier than taking them off “dry.”POSTOPERATIVE VISITS: Your first visit post-op visit will be 3 or 4 days after surgery, once the tape or foam has been removed.EXPOSURE TO SUNLIGHT: It is very important to protect your incisions from the sun. Keep your chest completely covered until your incisions have closed (approx. 2 weeks). After that time, you must wear a high grade sunscreen on your incisions for a minimum of 12 weeks to ensure optimal healing of the scars.ACTIVITY: You should start moving around once you up to it. Moderate walking around will help promote healing. Listen to your body, it will tell you if you are doing too much too soon. Do not return to strenuous activities or aerobic exercise for 4-6 weeks. If you want to know what activities are acceptable at any time during the healing process, please call our office.Specific as you heal informationBRUISING AND SWELLING: Bruising and swelling are normal and usually increase slightly after the removal of any tape or foam. The bruising will decrease over 3-4 weeks, but may last as long as 6 weeks. The majority of the swelling will be gone within the first 3-4 weeks. However it may take 6-9 weeks to disappear completely. The compression garment helps reduce the swelling, and the longer it is worn, the more quickly you will heal.#gynecomastia#malebreastreduction#manboobs

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients to experience swelling
following liposuction for male breast enlargement. The majority of swelling
resolves in four to six weeks, but may persist for up to six months.

The
use of compression garments and massage can help to minimize swelling and
shorten the recovery period following surgery. It’s important to start
compression immediately after surgery before the swelling gets started. Once
swelling occurs compression may not be as effective.

If
this problem persists beyond six months it may be more then residual swelling.
Under these circumstances unresected glandular breast tissue may be the
problem. This may ultimately require revisional surgery. It’s important that
you discuss these issues with your surgeon. He will be able to make an
appropriate recommendation.

Richard H. Tholen, MD, FACS · Answer

Based on how you stated your question, and your photograph, I infer that preoperatively you only had swelling and/or fullness beneath the nipple/areola complex. This would mean that your degree of gynecomastia was minimal, and likely due to true glandular tissue being present and not just fatty tissue. With over twenty years of doing these procedures, I can tell you truthfully that liposuction alone, without direct excision of the fibrous, firm glandular tissue by your surgeon, will not correct your initial concern. Even when the swelling and scar tissue subside, you will still have the firm tissue beneath this area, minus a small amount of fat, plus a small amount of scar tissue = not much change. Compression helps with swelling or scar tissue, and is certainly appropriate and non-harmful, but compression will not get rid of the tissue that SHOULD have been removed by direct excision with blade and/or scissors. Liposuction all too often makes a minimal degree of improvement in patients with mostly glandular gynecomastia, and really works well only in patients who have mostly fatty "man-boobs," usually from being overweight. Mixed glandular/fatty gynecomastia requires a combination of direct excision plus liposuction techniques. BTW, ultrasonic or laser-assisted lipo may remove a bit more gynecomastia tissue, but still leaves the fibrous, glandular breast tissue and a less-than-happy patient.

Otto Joseph Placik, MD · Answer

SEE SAMPLE VIDEO RESTULTS BELOW BY CLICKING MORE:
This can occur for some time after surgery. Light compression can be useful and I often have people covert from the uncomfortable restrictive post op garments to spandex type "under armor" shirts for up to 3 weeks after surgery.
Manual lymphatic drainage, as mentioned, may be beneficial as well.
Give this at least 3 months

Babak Dadvand, MD · Answer

Hi forbsey4,Thank you for your post.  At 5 weeks you are relatively early in the healing process. I do not feel a compression vest will be much benefit at this point. However, you should also make sure that there is no other reason for your swelling, namely an untreated seroma, or fluid collection. I recommend you follow up with your surgeon regarding this. As for needing another surgery, I would wait at least 6 months to allow the surgical area to settle.Sincerely,Dr. Dadvand

Mordcai Blau, MD · Answer

Give it 6 months and see if the swelling will improve and disappear.If not you probably have residual gynecomastia,glandular tissue that will have to be excised if you want it to be resolved. A board certified plastic/ experienced gynecomastia surgeon should be able to help you. IN WIKIPEDIA GYNECOMASTIA you can get more information.

Pat Pazmino, MD, FACS · Answer

After liposuction for the correction of gynecomastia, it is common to have significant swelling. Your body is currently healing and tissue needs to settle. It is extremely important to use a compressive garment after liposuction. This garment allows these swelling to subside quickly and also allows the skin to stick to the underlying muscle in a nice smooth fashion.

Steven Wallach, MD · Answer

Perisistent swelling from liposuction can occur for several months after the liposuction procedure.   You have to give some more time for the swelling to subside.

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