Still Have Puffy Nipples After @ Male Breast Reduction Surgeries, Could This be Excess Gland? (photo)

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.

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.

Some glandular tissue behind the areola might persist after liposuction. When swelling is totally resolve this can be easily reduced under local anesthesia.

       You could have residual swelling, scar, or residual gland.  I would give yourself another 3 months before making any decisions about this.  I would also say that you appear to have a flat chest and a good result.  Removing all of the tissue under the areolae can cause depressions.

 

 

Kenneth Hughes, MD Los Angeles, CA

You are likely experiencing residual tissue under the nipples. Seek a plastic surgeon with specialty training in #gynecomastia surgery, has great photos, and is an expert in male breast reduction.

Often times liposuction alone for gynecomastia unmasks a residual mass of tissue right under the nipple after the swelling subsides. This becomes the so-called puffy nipple problem. This hard glandular tissue can not be removed by liposuction and will require a secondary open areolar excision to create a complete flattening effect.

I usually use a two pronged approach to gynecomastia.  First liposuction followed by an open subcutaneous mastectomy.   There usually is a small amount of firm breast tissue just under the areola that can not be liposuctioned.  It is possible that your plastic surgeon felt that he sufficiently reduced your breast without having to make an incision.  This, of course, would be an ideal case scenario.  If there is residual breast tissue then an open revision would be necessary.  Give it at least 6 months to be able to differentiate between scar tissue and breast tissue. 

While you have not provided preoperative photographs with which to compare, your post operative photos demonstrate a reasonable result following liposuction.  However, persisting subareolar fullness is frequent as liposuction cannot remove the glandular tissue.  A revision to directly excise the subaerolar gland will likely address your concerns.