Puffy Nipples Month After Gynecomastia Surgery, Is This Normal? (photo)

Question

hi, i had gyno surgery 4 weeks ago now on both sides via lipo & incision, i have noticed a big difference in the right areola as it is only a little bit puffy now, However my left areola is still puffy, is this normal at 4 weeks ? whats causing this? any help?? my surgeon has said he doesn't know if its going to get flatter and hes ment to be one of the best in the uk.

Jed H. Horowitz, MD, FACS · Answer

Following surgery, 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.

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

At 4 weeks post-op there will still be some swelling and it is too early to assess the final appearances. Your surgeon will usually assess you at least 6 months down the line to see whether, if still present, there are additional procedures that will improve this.

John Nguyen, MD, FACS · Answer

Give it more time to heal.  After 6-8 months, your surgeon may re-evaluate and determine whether you will need further subareola tissue excision to reduce the prominence of the areola.  Good luck and be safe.John T.
Nguyen, MD, FACS, FICSDouble Board
Certified Plastic Surgeon

David F. Pratt, MD · Answer

At 4 weeks post-op, your recovery is still in its infancy,
and your result will continue to change for up to a year.  The most rapid change following gynecomastia
surgery is seen during the first 6 weeks, but even long after that, there are
significant changes that usually occur.  I would advise you to think of your surgery like this.  You bring your
car in to the paint shop to be painted.  They tell you to come back in 2 weeks, but you peek in the window at 1
week and you are not happy with what you see.  Surgery is the same way, but on a longer time scale.  You need to patient, but its hard to do.Under normal circumstances, the only conditions that absolutely require surgery in the
early post-op period are fluid, blood or pus collections, wound separation, or
tissue necrosis (death).  Otherwise, the
general rule in surgery is to wait at least 4-5 months for most of the swelling
to resolve and the majority of healing to occur.  At that time, an evaluation of your condition
would determine if you need revisional surgery.I hope this answers your questions.   Good luck!

Babak Dadvand, MD · Answer

Hi balgownie,Thanks for the post and the photos. It appears that your result at one month is quite good. Final results can take up to six months so be patient.  The important question is whether the left nipple has been puffy since right after the surgery or whether it has started to become puffy again. This is important because there is a chance that you may be developing scar tissue under the left areola or that there is residual breast tissue. I recommend you keep in close communication with your surgeon. Sincerely,Dr. Dadvand

Jeffrey Zwiren, MD · Answer

Many times puffy nipples in males is associated with gynecomastia. When the gynecomastia is corrected the nipples generally shrink down as well.   You just need more time for the condition to resolve.

Tom J. Pousti, MD · Answer

Thank you for the question  I have pictures.

	It is still too early to evaluate the end results of your surgery. Keep in mind, that some asymmetry is likely to be present after any  type of surgical procedure. It will be much better to have slight &ldquo;puffiness&rdquo; as opposed to a crater deformity secondary to over resection.

	I would suggest that you allow for several more months to pass before you evaluate the end results of the procedure. In the meantime, refrain from unnecessary &ldquo;worry&rdquo; (since this does not help),  allow time for skin contraction, and continue close folow up with your plastic surgeon.

	 

	Best wishes.

Darryl J. Blinski, MD · Answer

The posted photos demonstrate a very EARLY healing of the N/A complexes. Allow at least 2 months before concerning yourself about further revision.

Steven Wallach, MD · Answer

Puffiness in the areola may be dues to swelling.  It is too early to see the final result. Give it some more time.

Robert L. Kraft, MD, FACS · Answer

Four weeks postop, this wouldn't be unusual and will need to settle down.  If you are unhappy with the shape of the nipple in the future, it can certainly be revised but this is nothing to rush into.

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