8 Months Post Gyno Surgery - Will my Internal Scar Tissue Disappear? (photo)

Question

I had Gynecomastia surgery 8 months ago. As you can see from my photos I have developed internal scar tissue. My nipples are puffier than they we're before my operation. I can feel that the scar under my left nipple is no bigger than my areola in diameter, where as my right is significantly larger in diameter but slightly flatter and slightly less noticeable. Why? What are my options? Is cortisone injections a good option? If I re-excise wont the scarring just reappear? Please help!

John Nguyen, MD, FACS · Answer

I am not sure of the "scarring" that you are referring to.  It does seem that you may need additional excision of breast tissue, in particular under the nipple areola complex.  Good luck and be safe.John T.
Nguyen, MD, FACS, FICSDouble Board
Certified Plastic Surgeon

Tim Neavin, MD · Answer

I am a fan of kenalog injections to soften the scar that develops under the areola after gynecomastia surgery.  It is most effective within the first 3 months.  In your case, it may be gland, which is not a big deal.  It is always better to have too much left than too little.  The resection of more gland can be done under local anesthesia.

Jed H. Horowitz, MD, FACS · Answer

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.In the future, if you are concerned with scars, with your surgeon's approval you may be able to use scar management treatments such as Biocornuem,  Scar Guard, Scar Fade,  IPL Laser,  Yag Laser,   5fu/Kenalog for thick scars, or silicone sheeting.

Stephen Bresnick, MD · Answer

Your photos demonstrate that you likely have additional breast tissue in the chest area. Sometimes, scar tissue can exacerbate this appearance. Steroid injections alone are unlikely to solve the problem. Additional breast tissue excess under the nipple is also supported by the enlarged areola, which is stretched by the breast tissue. It would be a good idea to see your surgeon or a second opinion by an exerienced, board-certified plastic surgeon

Kenneth Hughes, MD · Answer

After 8 months, you may have residual tissue, but this would be difficult to determine without an exam. With regard to widening of areola, this can occur as healing takes place. Kenneth Hughes, MD male breast reduction Los Angeles, CA

Babak Dadvand, MD · Answer

Hi NiTx,Thanks for the post and the photos. Based on your photos and the fact that you are 8 months post surgery, you will not get any more improvement without some sort of intervention.  If your chest contour was very good right after surgery and then began getting firm and puffy under the areola, then this is likely scar tissue and may benefit from kenalog injection. If there was fullness under the areola right after the surgery, then it is likely residual breast tissue and will need surgery to remove. SIncerely,Dr. Dadvand

Deborah Ekstrom, MD · Answer

The fullness might be scar, but more likely is some leftover breast tissue.  Its important to leave some tissue under the areola so it doesn't "cave in" and sometimes it is difficult to get it exactly right.  An exam by your surgeon will help to differentiate scar from left over tissue.

	If it is scar, steroid injections and massage might help.  If it turns out to be a little too much tissue, a revision may be the right answer.  Revisions shouldn't be done too soon, so be patient. 

	I don't think you need to rule out revision for fear of more scar formation, if that is what you decide with your surgeon.

Darryl J. Blinski, MD · Answer

Yes I see the issue. First try the Kenalog injections over a 3 to 6 month time frame. Than if not improved get revision surgery.

Samir Shureih, MD · Answer

I believe you need revisional surgery. You still have significant breast tissue and may be fat.

	You can wait couple of months and see if there is any change.

	Get another opinion

Steven Wallach, MD · Answer

You  may need revision of your gynecomastia procedure if not all the tissue was removed under the nipple. This can be more glandular tissue and difficult to treat without excision.

8 Months Post Gyno Surgery - Will my Internal Scar Tissue Disappear? (photo)

Answers (11)