Constant pain a year after gynecomastia surgery. What can be done about this? (Photo)

Experiencing constant pain a year after gynecomastia surgery is unusual and warrants medical evaluation. Here are some steps you can take to address this issue:
1. Consult Your Plastic Surgeon: Return to the plastic surgeon who performed the procedure. They will have the most insight into your specific case and can assess whether the pain is related to the surgery.
2. Pain Assessment: Describe the nature of your pain in detail (sharp, dull, constant, intermittent, etc.) and any other symptoms you might have. This can help in diagnosing the underlying cause.
3. Imaging Studies: Request imaging studies such as an ultrasound or MRI. These can help identify issues like scar tissue formation, residual glandular tissue, or other complications that might be causing the pain.
4. Nerve Pain: Chronic pain can sometimes be due to nerve damage or nerve entrapment. A specialist in pain management or a neurologist might be able to offer treatments such as nerve blocks, medications, or physical therapy.
5. Physical Therapy: Sometimes, physical therapy can help alleviate pain by addressing muscle imbalances or scar tissue adhesions that might be contributing to your discomfort.
6. Medication: Pain management through medication might be necessary, but this should be done under the guidance of a healthcare professional to avoid dependency and manage side effects.
7. Lifestyle Modifications: Sometimes, modifications in activity levels or changes in habits that might be exacerbating the pain can be beneficial. A healthcare professional can provide guidance based on your specific situation.
8. Surgical Revision: In some cases, a secondary surgery might be needed to correct any anatomical issues causing the pain. This should be considered carefully and typically as a last resort after other options have been explored.
It’s important to address chronic pain promptly to prevent it from becoming more ingrained and difficult to treat. Working closely with healthcare professionals will give you the best chance of finding a solution.

To make an assessment regarding the outcome of any plastic surgery procedure. We need to see a complete set of proper before and after pictures.
If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took.
There are three tissue variables that determine what the Male chest looks like.
They are skin laxity, subcutaneous, fat, and excess glandular breast tissue.
It’s important to differentiate which tissue variables are contributing because this determines your candidacy for the procedure and what kind of results should be anticipated.
The best way to differentiate between skin laxity, excess subcutaneous, and glandular tissue is to put the pectoralis muscle and the skin under tension.
Do that by putting one arm behind your head like you’re scratching your upper back.
Do it with one arm at a time while someone else takes pictures of your chest.
With the skin and pectoralis muscle under tension, you should be able to clearly differentiate how much of the fullness is due to excess glandular tissue and how much is due to skin laxity.
Look at the contour of your chest as you put your arm slowly down into a normal position.
This will show you how much skin is contributing.
Breast tissue can hurt.
Most women have intermittent breast pain and so do some men who have gynecomastia.
Sensations after surgery can take several months to settle down. Period.
Pain after surgery isn’t something that surgeons are able to correct.
Pain after surgery is unfortunate, but there is no operation to correct this.
You can consider results fairly close to final by six months.
Skin incisions can continue to change for 12 to 18 months.
Of the three tissue variables, skin laxity is by far the most difficult to treat.
Excess subcutaneous fat can be removed with liposuction and glandular breast tissue is best removed with open direct excision.
Skin laxity does not have any great treatments other than a formal chest lift, which is a bit brutal for most guys.
As sufficiently skilled the inexperienced plastic surgeon should be able to make a quality assessment differentiating between each of these tissues.
Making a quality assessment should make outcomes highly predictable.
Mastering this kind of work is difficult and the number of plastic surgeons who can deliver consistent quality outcomes, and predict what surgery outcomes will look like during consultations is not all that common.Doing this kind of surgery well on consistent basis is more difficult than most people realize.In the end, patient candidacy and provider selection are the two most important variables and generally dictate most plastic surgical outcomes.
Some people are better candidates for quality outcomes than others.
Understanding your candidacy is an important part of high patient satisfaction.
The patient who is an excellent candidate for a plastic surgical procedure has the potential of having an excellent outcome if they choose the right provider.
A patient who is not an excellent candidate for a procedure does not have the potential of having a high-quality outcome, regardless of who does the surgery.
Like I mentioned earlier the ability to differentiate and make a quality assessment is much more difficult than most people realize and the number of plastic surgeons who can do. It is kind of work with accuracy and precision is not that common.
Best,
Mats Hagstrom MD