Gynecomastia returning? Puffy nips after surgery. (photo)

Question

Hi, I had gynecomastia surgery 2 months ago. My chest was really flat 1 week post op and I couldn't believe it. Ever since then, it's becoming more fuller. Unfortunately, I don't have 1 week post op pictures - but my chest is not flat anymore and right side nipple is puffier. I don't feel any hard tissue, except on the sides of aerola. Is this scar tissue? Pre and Post (8 weeks) photos attached. What should I do? Thanks the help

Jed H. Horowitz, MD, FACS · Answer

Following #Gynecomastia #surgery, your incisions will go through a maturation #process. For the first few months they will be red and possibly raised and/or firm. As the scar matures, after 6-12 months, it becomes soft, pale, flat, and much less noticeable. You may experience numbness, tingling, burning, “crawling”, or other peculiar sensations around the surgical area. This is a result of the #healing of tiny fibers which are trapped in the incision site. These symptoms will disappear. Some people are prone to keloids, which is an abnormal scar that becomes prominent. If you or a blood relative has a tendency to keloid formation, please inform the doctor.

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. Also, as you heal, the area may feel “lumpy” and irregular. This, too, decreases with time, and massaging these areas will help soften the scar tissue. The #compression garment helps reduce the swelling, and the longer it is worn, the more quickly you will #heal. It can also assist in the retraction of the skin. If you have any concerns about #healing, its best to ask questions of your surgeon or their nursing staff.

The #recurrence of breast enlargement is uncommon following #gynecomastia surgery.However, it can occur. If this happens, you may require further surgery in the future.Each patient is unique and previous #results are not a guarantee for individual outcomes. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation

George C. Peck, Jr, MD · Answer

Gynecomastia surgery is an art as well as a science. If a surgeon over-resects the tissue under the areola, the surgeon may cause a depression. The small amount of puffiness still may get better with time. In some cases, the surgeon may inject a local steroid into this tissue to remove inflammation and create subcutaneous atrophy.In other cases, fluid can accumulates under the areola. This fluid may need to be removed by needle aspiration.Consult your surgeon. Best wishes.

Parham Ganchi, PhD, MD · Answer

The only photo that I can see is your preoperative photo.  If you chest was flat after surgery, then this is a good sign that it will be flat once the swelling and inflammation settle down.  This should happen within the first 3-6 months.  It is also possible that the gland was not removed (if you only had liposuction) and that as the swelling is going down, the gland is showing itself.  Speak with your plastic surgeon to review this.  Take care.Parham Ganchi, PhD, MD - NJ Plastic Surgeon

Jonathan J. Staiano, FRCS (Plast) · Answer

Hello there, I can only see your preoperative photograph but it is a good sign that your chest was flat immediately postop.  This suggests that it is swelling causing the puffiness.  I tell my patients that the swelling can go up and down in the first few months following surgery and takes about 3 months before things start to settle.  It can then take 6, 12 or even 18 months until everything has fully settled, so it is still early days for you.  Stick with it and be patient.  Good luck.

Frederic H. Corbin, MD (license restricted) · Answer

Your post op photos did not appear but I would also need to know whether you had excision or liposuction.  Obviously it could be swelling but if you only had liposuction it could be residual tissue.

Dr. Corbin

Gynecomastia returning? Puffy nips after surgery. (photo)

Answers (5)

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