Results from Gynecomastia Surgery After 6 Months - Puffy Nipples?

usually puffy nipples are either caused by excess breast gland under the nipple or by excess scar tissue. In either case, you might consider excising breast tissue through a very small incision through the areola.

After #Gynecomastia #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.

Minimal gauze dressing is applied following the procedure and an easily concealed support elastic garment is usually worn to minimize swelling and help skin to contract for a 3-4 weeks following surgery. Sutures are typically removed within 7 to 10 days of surgery.Patients engage in gentle activities of daily living for the first 10 days. No aerobic exercise for at least 3 weeks. Patients may take gentle walks after a few days.

You may want to get a second opinion, or return to your surgeon to talk about your results. Massage may help but you'll most likely benefit from revision surgery.

                  It’s
not uncommon for patients to note contour irregularities following gynecomastia
surgery. The majority of these cases occur because of scarring and swelling and
resolve with time. This resolution can be facilitated with compression garments
and massage. It typically takes six to twelve months to see a final result
following surgery.

                  When
residual contour irregularities persist for longer periods of time, this may be
due to incompletely excised breast tissue. This commonly occurs in the sub
areolar area and often results in puffy nipples. When this situation arises,
revisional surgery is often necessary.

                  It’s
important that you consult your surgeon so that you can be re-evaluated. A
physical examination should determine whether revisional surgery is necessary. 

Yes, it can be normal to have puffy nipples for 6 months after surgery but it really depends on what was done. If a circumareolar incision was used, it is not uncommon to have the puffiness persists for several months.

Thanks for your question. I think swelling and temporary scar tissue maybe prolong puffy nipples after surgery. At 6 months, swelling should be minimal. I would suggest you meet with your surgeon for an evaluation. Sometimes the gland that is left under the areola to keep it flat needs to be revised. 

Hi rff,Thanks for the post. Typically six months is enough time for the healing process to have settled significantly.  The fact that your nipples began getting puffy again a month after surgery points more to the fact that it is likely scar tissue formation. If it were residual gland, they would have been puffy right after surgery. There are massage techniques and even kenalog injections that may help break up the scar tissue. If that does not work, then you may need a revision surgery. Sincerely,Dr. Dadvand

During the healing and recovery process, there should be communication between you and your surgeon. If you are not happy, this should be communicated with your surgeon. Ask how and when revision surgery is performed. 

Under normal circumstances, 6 months should be enough time
for the great majority of swelling to have resolved following gland excision
and liposuction of gynecomastia.  Possible reasons for persistent subareolar swelling would include
under-resection of the glandular tissue, post-op bleeding into the subareolar
“dead space” with subsequent thick scar formation, regrowth of the gynecomastia
glandular tissue, or post-operative weight gain in the case of
pseudo-gynecomastia.Treatment of residual “puffy nipples” would depend on the
exact cause.  Thick scar tissue can be
treated with aggressive massage and/or corticosteroid injections directly into
the scar tissue.Under-resection of the
gland or regrowth may require additional surgery to correct and possibly a
thorough endocrine evaluation to rule out a continued stimulus for the growth
of the breast tissue.  Persistent or
worsening fatty deposits in the breast area may be treated with additional
liposuction, and post-operative weight gain should be addressed with a healthy
diet and exercise.I hope this answers your question.  Good luck!