3 months post op gyno. Still looks swollen and puffy? Advise? (photo)

Question

I had gyno surgery 86 days ago and have just had my last checkup. My doc said everything is good but I still think it looks like gyno. The left side still has puffiness under and slightly around the nipple making a protruding look. Right nipple is less puffy. I can see the puffiness through shirts and makes me worried its permanent. I know theres scar tissue under the nipple but dont see how it would cause the soft and puffy nipple. puffiness seems to be worst the day after massaging the scar

Kenneth Hughes, MD · Answer

Recovery is patient dependent but is also is affected by the surgical technique employed.  You may notice swelling becoming minimal before six months and final results before 12.  Follow your plastic surgeon's post-operative guidelines to ensure the best results possible.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Miguel Delgado, MD · Answer

Swelling at 3 months is normal, it may be another 3 to 6 months before you see your final result. Discuss your concerns with your surgeon. Be sure to follow all post operative instructions, and try to be patient. Good luck.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. If you are unhappy with the results, you need to discuss that with your surgeon. If your surgeon does not share your assessment, then consider a second opinion with a plastic surgeon who is board certified by the American Board of Plastic Surgery.Good luck!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Matthew A. DelMauro, MD, FACS · Answer

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) It is still early after your surgery. Swelling often takes 3-6 months to resolve. External and internal scars soften with massage and with time. The puffiness may resolve. Be patient, and follow up with your plastic surgeon. Best of luck!
Matthew A. DelMauro, M.D.

Eric Desman, MD · Answer

Thank you for your question and photos. The final results from this surgery take about 9-12 months because your skin needs to contract after removal of the tissue. The best thing to do is to raise your concerns with your surgeon. I know it is difficult to "just wait", but that is likely the best thing to do at this point. I have seen many people have excellent long term results with exams that look like yours at 3 months. Good luck.

Michael Law, MD · Answer

It is important to share your concerns with your plastic surgeon. Plastic surgeons want their patients to be happy and confident. If you haven't shared your concerns, they may feel like you are happy. In some cases exam rooms can be cold, and patients can be a bit nervous. This can be frustrating as a patient may have puffiness at home that the plastic may not see in consultation. Most plastic surgeons that perform a lot of gynecomastia will be patient so they can what the patient is seeing. It might be helpful to take photos to share what you look like when warm, maybe just out of the shower. By the three month point, most healing should be complete, but you may still experience some improvement. In the event that this issue does not resolve, a revision surgery could provide you the result you are hoping for. Ideally, your initial procedure could perform this procedure for you. In the event that you elect to seek out a different plastic surgeon, find a plastic surgeon who performs a lot of gynecomastia surgery, including gynecomastia revision.

Mats Hagstrom, MD (license on probation) · Answer

not sure what you're looking for here. Do you want us to tell you that you're correct?  That you still have a gynecomastia?  I have no idea what procedure was performed or how it was done, who did it etc. etc.  The correction of gynecomastia is typically done with a combination of liposuction and an open excision of breast tissue underneath the Ariola. Revisions are much more common  then people believe. Probably 10 to 25%. Talk to your plastic surgeon and bring up if the revision is indicated. If you are you getting more swollen from massage then don't do massage.  All men have some fullness because all men have breast tissue. We don't call it gynecomastia it's simply normal. Some people have a little more than others.  Carrying extra weight can make it worse. If you did not have an open excision of the breast issue then you may need this if you want a better correction. When this is done incorrectly it can lead to indentations which can be difficult to fix but a good plastic surgeon should be able to get you the results you want if your results are dialed in with what can be achieved. Talk to your plastic surgeon about your concerns. Best, Mats Hagstrom M.D.

David E. Berman, MD (retired) · Answer

you need to be far more patient. I don't believe that there is anything you can do to speed up your final result. it just takes time. It is not unusual at all for men this early on after a gynecomastia correction to still feel that their nipples are swollen etc. I think it would be a mistake to do anything about this so early after your surgery. try not to assess them so frequently and try not to obsess over this. you will only drive yourself nuts. David Berman MD

Robert E. Zaworski, MD (retired) · Answer

It can take several weeks to months to see your final result after gynecomastia surgery.  Massages may help.  Ask your surgeon for any and all recommendations to expedite the healing.

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