4 weeks post op, my nipple is folding. Does such nipple crease actually go away with time? (photo)

My left nipple was creased since day 1 post op. My doctor said that it is normal and will improve with time. Now it is almost 4 weeks and I feel that the nipple is folding further instead of getting better. Does such nipple crease actually go away with time? What are the chances of me getting a normal nipple without needing to go for correction surgery?

Doctor Answers 4

Healing & Assymetry After Gynecomastia Surgery

Asymmetry during the healing process is not at all uncommon after any breast surgery. Also, your incisions will go through a maturation #process following #Gynecomastia #surgery. 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.


Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Nipple crease

It will probably get better. Check with your surgeon about massage. it might help it smooth out quicker.

Folded nipple after gynecomastia surgery.

Having the "creased nipple" go away is the goal, and in many patients it will do just that as the scar tissue that adheres the nipple areola skin to the underlying tissues softens and stretches. The problem is that not every surgeon leaves a small disc of tissue beneath the nipple/areola complex to soften and minimize this unnatural adherence, and in those unfortunate cases, this only gets worse.

At this point in time, only your surgeon knows just how much or how little tissue remains, and this is such a common issue that only time will tell. Patients want "as much as possible" of their abnormal gynecomastia tissue removed, and (how do I put this delicately?) plastic surgeons who don't do this operation frequently are often quite eager to "get it all!" when in fact, a disc of tissue MUST be retained beneath the nipple/areola skin in order to prevent abnormal adherence to the underlying pec muscles. Your surgeon may have done everything perfectly, and this will gradually settle and be fine.

It's hard to tell from one photo if you have that concern or not, but for now, there's nothing to do but wait and see anyway. I would recommend massage to help soften and stretch any scar tissue you do have present, but you should wait at least 6-12 months before considering revisionary surgery (fat grafting). Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 240 reviews

Creasing

This is fairly common problem and it may be temporary. The challenge with male breast reduction is to reduce enough of the breast volume to achieve the cosmetic result  while leaving enough tissue underneath the nipple to avoid  a depression. I usually ask my patients to massage this area in hopes to break up any early scarring that might be causing this. If ineffective- sometimes a revision is necessary. I would ask your surgeon if they recommend any treatment for this. It usually takes 3 months to see resolution in my experience.

Glenn Lyle, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 10 reviews

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.