3 weeks post op of Gynecomastia surgery, I'm worried about water collection. Is this normal?

I went through gynaco surgey about 3 weeks ago and i started collecting water on right side beneath nipple area.. My doctr has done aspiration 2-3 times still i keep on collecting water but in less amount than before now.. I would like to ask if this is normal and is their any problem associated to this.. The place where the water is getting collected is a bit shallow due to the breast tissue removal .. I heard my doctr speaking to his junior as SEROMA which i really dont know about

Doctor Answers 5

Worried About Swelling or Fluid Post Op

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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.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Compression garment

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I recommend my patients wear their garments for a minimum of 3 weeks if not a lot of redundant skin following liposuction male breast reduction to a maximum of 6 weeks. To be effective the garment needs to fit snug but not too tight as to cause pressure problems (inspect your skin if discomfort and when skin is exposed), or prevent you from sleeping. As the edema resolves it is common for patients to switch to a smaller garment that fits - A Spanx type garment would work rather than ordering one or paying more at your doctor;'s office.
Male Breast Reduction (Gynecomastia Reduction) by liposuction requires compression garments for three main reasons:
  1. it restricts the amount of edema that forms and hastens its resolution by mechanical pressure
  2. It decreases the amount of bruising
  3. It assists the loose skin in retracting or shrinking

Postoperative seroma after gynecomastia usually treated by sequential aspirations.

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A postoperative seroma is occasionally seen after gynecomastia excision. Usually sequential aspirations in the office will lead to complete resolution.

This sounds very similar to another question I answered for another patient - here is my response.

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Hello Sam1991

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.

Joseph B. Eby, MD, FACS
Beverly Hills Plastic Surgeon

Seroma/ fluid after gynaecomastia surgery

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Hi, thanks for your question. 

Approximately 10-15% of men develop seroma formation after gynaecomastia surgery, however, probably only 5% require intervention (syringe aspiration etc) and very few ever require repeat surgery. As such, I wouldn't be concerned at the moment as I'm sure there's nothing to worry about. 

A seroma is a collection of straw coloured, thin fluid produced by traumatised tissue as a component of the inflammatory response. Damage to the body's lymphatics can also add to this fluid accumulation. Typically, following repeat aspirations this should settle of its own accord, particularly with the use of a compression garment for a number of weeks. Seromas are more common in people carrying excessive body weight. Unless you show signs of infection (redness, tenderness, increased swelling, fever, chills or a possible wound discharge in the early post op period ) I would just be patient and let things settle. 

Your specialist Plastic Surgeon would have seen this many times and will be more than capable of managing it. You're in good hands. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.