Left Side Looking Bigger Than Right Side After Gynecomastia Surgery

Question

Hi I have had a gynecomastia surgery to both sides of my chest, but after a week the left side looked the same prior to the surgery. It has been 3 1/2 weeks now and the left side is still looking the same while the right side has decreased. What should I do?

Michael Constantin Gartner, DO · Answer

It's still too early to judge your results. Best to give it a couple of months for the swelling to subside and things to even out.

Jed H. Horowitz, MD, FACS · Answer

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.

Tim Neavin, MD · Answer

Some asymmetry is normal throughout the entire process start to finish.  Breasts start off asymmetrical, liposuction and glandular excision is somewhat different to small degrees, swelling will be asymmetric, healing is different, and the results will necessarily have some asymmetry.  Big asymmetry is uncommon and could be corrected generally in the office after 3 months under local anesthesia.

John Nguyen, MD, FACS · Answer

It is too early to assess the symmetry or outcome of your surgery.  Give it 6-8 weeks and communicate any concerns with your surgeon.  Good luck and be safe.John T.
Nguyen, MD, FACS, FICSDouble Board
Certified Plastic Surgeon

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients to experience asymmetry
following the surgical management of gynecomastia. In the immediate
post-operative period, swelling and scarring may contribute to this asymmetry.
It takes about six to twelve months for swelling to spontaneously resolve. In
the majority of cases, patients are happy with their symmetry, once this
occurs.

Unfortunately
in a small number of patients, asymmetry persists after the resolution of
swelling. When this occurs revisional surgery is often necessary.

It’s
still very early in the post-operative course and your asymmetry may be related
to swelling. This swelling can be minimized by utilizing compression garments
and massage. Be patient and make sure you discuss your concerns with your
surgeon.

Miguel Delgado, MD · Answer

I understand your concern. Was the procedure liposuction only? Was your chest asymetrical before surgery. Sometimes more work is done on one side causing more swelling. I would give it 6 weeks wear your compression garment and then discuss your issues with the surgeon.

James F. Boynton, MD, FACS · Answer

I would say to still wait until its been 3 months and then you can fully evaluate, but probably there is a bit more residual fullness on the left side. Oftentimes, the breast tissue may have been asymmetric before. It depends on the technique that was done in the surgery.  If it was only liposuction, or VASER, or ultrasonic or even laser liposuction I think there still will be fibrous tissue under the nipple that stays full. I think you have to include an "excisional" component to get the ideal flatness most patients are seeking.  I perform an aggressive chest wall liposuction with "pull through" excisional technique to remove that residual tissue.  This gives a nice flatness to the chest and the nipple/areola and often the areolar diameter shrinks as well which most men want. I would think you may need a "revision" where the excisional component can be added if you go to a board certified plastic surgeon that performs the minimal incision excisional technique as I do.  I hope this helps!

	Sincerely,

	James F. Boynton, M.D., F.A.C.S.

David J. Levens, MD · Answer

Asymmetry is not uncommon both before and after surgery.  It is early and your result will likely continue to improve.  Two significant  early factors are tissue swelling which takes time to resolve and more dramatically there can be a collection of fluid making one side look bigger.  This can be easily drained with a needle in the office.

Joseph Michaels, MD · Answer

There may be several reasons why you may be noticing asymmetry and they are best addressed by your plastic surgeon. Did you have an excisional procedure or just liposuction. If just liposuction is performed, it is sometimes difficult to remove the dense breast/glandular tissue and this might be what you see. There could also be natural differences in your chest that you are just knowing. You can also get fluid collections of either normal inflammatory fluid (seroma) or of blood (hematoma) that can be drained. Again, it is best to address these issues with your surgeon. Best of luck.

Otto Joseph Placik, MD · Answer

All breasts are uneven and to some degree this is normal. If however, there is a dramamtic difference between the two, I would discuss tis with your surgeon. Perhaps you have a hematoma/seroma that needs to be drained or perhaps you will require further surgery to reduce this even more.

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