When to start massaging scar tissue after gynecomastia surgery?

Question

I am 1-week post op from gynecomastia surgery. My right pec appears to substantially bigger and is starting to worry me that it will in fact remain so. I realize that is not uncommon for swelling to be unilateral but from what I can see the swelling has already reduced to where I expect it will stay. I am not quite sure how to identify what is scar tissue, and I am obviously still bruised and tender . When should somebody start massaging the area ? When will I be able to see the final result?

Nelson Castillo, MD · Answer

Thank you for sharing your question and congratulations on your surgery.  Depending on the gynecomastia procedures performed, it is likely that you still have significant swelling in your tissues that will need time to dissipate before your long-term results are seen.  It is important that any significant changes in appearance are relayed to your surgeon.  As for massaging I would contact your surgeon for advice as the risk of bleeding is higher in the first two weeks after surgery.  Best wishes.

Anthony Barabas, MBBS, FRCS (Plast) · Answer

Thanks for your question. You are still very soon after your surgery, so there will still be swelling from your surgery. I recommend leaving it at least 2 weeks after your scars have fully healed before directly massaging over the scars themselves, however you are best to follow the advise of your plastic surgeon.

Jed H. Horowitz, MD, FACS · Answer

Most likely your plastic surgeon will inform you at your follow-up appointment as to when you may begin #massaging. She or he will also instruct you on how to properly #massage the area for effective results. In the meantime, the following information about the healing process may help as well. your incisions will go through a maturation process. 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.

James Knoetgen, III, MD · Answer

After gynecomastia surgery, massaging scar tissue typically begins around 2 to 4 weeks post-surgery, once your surgeon gives you the green light. This is usually when the incisions have sufficiently healed and any significant swelling has subsided. Scar massage can help break down excess collagen, improve circulation, and promote softer, less noticeable scars. 
It’s crucial to follow your plastic surgeon’s specific guidelines, as they may adjust the timeline based on how your healing is progressing. Overly aggressive massaging too early could interfere with healing or cause complications.

Babak Dadvand, MD · Answer

Hi,Thanks for the post. At 1 week you are very early in the healing process. Swelling can be a factor but some other things that can cause asymmetric swelling at 1 week are bleeding (hematoma) and fluid collection (seroma). These would need to be evaluated by your plastic surgeon in person as massaging would not help in either situation. Sincerely,Dr. Dadvand

Ron Hazani, MD, FACS · Answer

Follow your surgeon's post op instructions.  You are still in early stages of healing and your surgeon who performed the procedure knows how and when you should start massaging.

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