I am 6 weeks post-op from having gynocomastia surgery and my nipples still look puffy. Will the puffiness subside with time?

Only ultra sonic liposuction was performed with no tissue excision. Im 6' tall 190lbs. The left nipple is not as puffy as the right nipple, however when my right pectoral muscle is flexed the nipple retracts and lays flat with the chest line. When standing normally with arms at my sides, it sticks out prominently. The left nipple is flatter with arms at my sides, but when pectoral muscle is flexed has a little bulge to it indicating underlying tissue. Is a revision a future possiblity?

Doctor Answers 4

Swelling after breast surgery

Swelling is a normal reaction to trauma or injury. Six weeks is still very early in the post operative period and it will likely be months before the majority of the swelling resolves. Changes in symmetry and improvement in tethering from scarring will continue during this period of time. Revisions can always be considered but it would be prudent to wait for at least six months before making a final evaluation.

Sacramento Plastic Surgeon
4.9 out of 5 stars 40 reviews

Question of Puffy Nipples After Gynecomastia

There is a question of whether or not there was intention to treat or even the areolae in your original procedure, and whether that needs to be corrected. If that is the case, after breast surgery the skin of the chest muscles will tighten, causing the areolae to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue. In order to be informed of what results can be achieved from surgery, men who desire to have this surgery should look at before and after pictures of patients who have undergone corrective surgery for the "puffy nipple" condition  Before the surgery, and then several months following the surgery.
Now, if you feel that the results of your procedure do not match what was agreed upon with your surgeon, then you should not hesitate at all to return to him in order to make sure that the final results of your procedure are completed appropriately.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Puffy nipples after gynecomastia surgery

Thank you for your question but I think you are premature about your final result.  It can take 6-12 months for the scar tissue to relax and take its final shape.  If you still have a problem after six months a revision can be done to remove the excess tissue and if you nipple still contracts on the right a release of the scar and a fat graft may improve it.  I would discuss this with your plastic surgeon and explain your concerns.  I would encourage you to be patient for now.

John D. Smoot, MD
La Jolla Plastic Surgeon
5.0 out of 5 stars 12 reviews

6 weeks post gyno excision - expectations and options

Thanks for your thorough description. At 6 weeks, it's still too early to judge the final result and make any decisions about the expected benefit of revision surgery. Nonetheless, it is a good idea to touch base with your surgeon just in case he/she has something to suggest (scar massage, taping, compression, etc.).

Assuming nothing changes over the next 6 weeks, then it might be reasonable to discuss the possible benefits of revision surgery. Questions you might ask are:
- which sides to revise
- what would be done
- type of anaesthetic required
- expected results
- recovery time and need for compression post-op

I hope this has been helpful. 

Owen Reid, MD
Richmond Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.