Puffy nipple and fluid build up after gynecomastia surgery. How long will the fluid be there? What are some warning signs?

Question

I had gynecomastia surgery 12 days ago and one side of my chest is very bruised, swollen and contains some fluid (blood). I had lipo plus breast tissue removal (I had a very mild case of gynecomastia). The surgeon already extracted the fluid on two separate occasions. He mentioned that if left untreated it could lead to uneven healing. How long should the swelling persist before it becomes an issue?

Jed H. Horowitz, MD, FACS · Answer

A collection of fluid under the skin occurs occasionally during the postoperative period. Aspiration of the fluid with a needle is frequently helpful. Secondary surgery is rarely necessary.

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.

Vincent N. Zubowicz, MD · Answer

Seromas should not be treated expectantly. Usually sequential drainage in the office by aspiration is enough to solve the problem.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Swelling is typically not an issue when it comes to healing but a fluid collection like a seroma is an issue. You have  had this fluid removed twice you should continue to wear your compressive dressings to minimize the chance of this recurring. If it does recur maybe a catheter or drain needs to replaced to help manage to

Salvatore Pacella, MD, MBA, FACS · Answer

Seroma is very common after gynecomastia surgeon.  Your surgeon is 100% correct in draining this.  Most of the time, the seroma will get smaller with each aspiration and eventually go away.  In addition to draining it, the key to reducing its size is external compression .  Confirm with your surgeon about compression garments.  If he or she feels this is a good idea for you, add a bit more pressure over the seroma with a folded washcloth or 4 x 4 dressings.

Jeffrey Zwiren, MD · Answer

You have developed a seroma or fluid collection in the space where the breast tissue was excised.  This is not uncommon and in most cases aspiration of the fluid takes care of the problem.  Compression also helps to decrease the shearing back and forth of the soft tissue.  This promotes more fluid build up.  Stick with the plan and you should have a nice result.

Joseph B. Eby, MD, FACS · Answer

It does sound as if you have a seroma or fluid collection. Most Plastic Surgeons do not leave a drain after gynecomastia surgery (unless it was a very large case). Even without drains fluid collections are uncommon after this operation, however they can occur.  The way I try to prevent them is by using Topi-foam or Reston-foam along with a compression garment immediately and for the first few weeks after surgery. Limiting your upper body activity will also help prevent the re-accumulation of fluid. Draining the seroma by removing the fluid with a needle or catheter is the proper way to treat this problem and may require several aspirations before the fluid no longer re-accumulates (the space collapses and heals eliminating the pocket).  If you are not using some type of compression garment I would add that to your recovery regimen along with limiting any upper body exercise. The swelling from gynecomastia is typically resolved by approximately 3 months a seroma should hopefully stop accumulating (depending on how large and how much fluid is accumulating) within a few weeks 2-4 typically.

Samir Shureih, MD · Answer

If you have seroma or hematoma after gynecomastia surgery, confirm by sonogram. Seroma or hematoma should be drained including the insertion of a new drain.

Puffy nipple and fluid build up after gynecomastia surgery. How long will the fluid be there? What are some warning signs?

Answers (7)

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