Alexander Q. Ereso, MD, FACS

Thanks for posting your photos. I would say that it is early to inject kenalog to reduce the scar tissue. Without having the ability to palpate the scar, I would imagine that the lump underneath your skin likely represent tissue being brought together by sutures as well as normal scar formation. It takes time to improve and most scar tissue eventually resolves such that there is nothing discrete underneath where you had your incision. 

Thank you for your question. Unfortunately, most insurance companies consider gynecomastia correction as a cosmetic procedure. Medicaid likely does not cover gynecomastia correction. However, your nipple pain may not necessarily be due to gynecomastia. I would advise you to see a plastic surgeon for consultation and examination. 

Thank you for posting your photos and congratulations on undergoing gynecomastia correction. Your question is shared by many who undergo procedures that involve both sides of the body. Due to many factors, some which cannot be explained, healing proceeds asymmetrically and usually involves one side healing faster than the other. Because a patient cannot help but compare one side with the other, seeing any difference sometimes can be a cause for anxiety. You might begin to think: "it that side not going to heal well?" or "is there a problem on that side?". My advice is to follow your surgeon's instructions and just allow your body to heal. 2 weeks is way too soon to determine if this will be your final result. Should you have any concern, don't hesitate to reach out to your plastic surgeon.

Thank you for your question and congratulations on undergoing gynecomastia surgery. It would be very unusual to have your gynecomastia recur after only 4 weeks. Likely, you are feeling residual scar tissue that you are only feeling now after all the swelling has subsided. However, if you have any questions, you should consult with your plastic surgeon and allow him/her to reexamine you. Good luck!

Thanks for posting your photos. There does appear to be a concavity which likely results from oversuctioning of that area. The ability to contour the chest to create a smooth appearance is just as important as the adequate removal of the glandular tissue. Experienced plastic surgeons know that what is important isn't so much of how much tissue was removed, but rather, the tissue which is left behind which leads to a smooth, contoured chest. Fat injections would be a much better option over implants. However, it is possible to target that area of your pectoral muscles with strength exercises which may improve the contour. My advice is to seek out an experienced, board certified plastic surgeon who is affiliated with the American Society for Aesthetic Plastic Surgery (ASAPS).

Thanks for your question and posting your photo. It does appear that there is residual tissue around your nipple which is blunting the edge of your pectoral muscle as it approaches your nipple areolar complex. Without examining your myself, it is difficult to determine what type of tissue is present. However, even after 4 months, you may have residual scar tissue which, if you continue to massage and let it soften, may improve the contour. I like to wait at least 6 months before I consider any revisions because sometimes, it is difficult to tell if residual gland is present or it is just slowly resolving scar tissue.

Like most things, post operative guidelines and restriction are on the conservative side so that it can capture within it's safety net, the most number of patients.  I advise patients to abstain from intense physical exertion, including sexual activities, for at least 2 weeks and sometimes up to 4 weeks. The instructions I give are tailored to each patient and depends on the amount of bruising afterwards, the extent of the surgery, and the type and duration of the activity. Your situation of requiring an aspiration of fluid on one side would make me advise you to hold off on physical activity until the fluid collection fully resolves. Follow up with your surgeon and ask his advice when you are allowed to return to playing table tennis.

Thanks for your question and posting your photos and congratulations on losing weight! Unfortunately, a physical exam is necessary to determine whether the heaviness of your chest is due to fat alone (lipomastia) of whether there is a glandular component (gynecomastia). You do appear to possess "heaviness" in your chest area and I suspect that there is a component of both fat and gland which is causing this. My advice is to seek a consultation with a board certified plastic surgeon with experience in treating gynecomastia. Good luck!

Thank you for your question. Most surgeons like to wait at least 2 days after surgery before allowing water to course over surgical incisions. By then, healing has occurred and the wound should be sealed from the outside. If drains are placed, I like to wait until they are removed before allowing a patient to shower. I think it is important for you to ask your surgeon what postoperative protocol they expect you to follow in regards to showering, removing of medical pads, and wearing of the compression garment or binder. It is common for the compression garments to be tight, however, you should discuss how the garment makes you feel so that the surgeon can decide if your size garment should be changed.

This is a very common question I get asked during consultations. My advice to patients undergoing not just gynecomastia surgery but most plastic surgery is to get close to your ideal body weight before surgery. I advise this for several reasons. First, getting close to your ideal weight allows me to obtain the best result. Losing the weight after surgery can affect your result in a detrimental manner. Finally, losing weight by exercising and eating healthier improves your cardiovascular health making you a better candidate to undergo a surgical procedure.