6 months post gynecomastia surgery concerns; options on what I should do next? (Photos)

My Dr. is a double board certified plastic surgeon that I really felt comfortable with, as I knew others who used him. However, I'm now 6 months post gyno surgery and my nipples are still puffy as can be. The rest of chest looks great and can see improvements. He continues to indicate I need to be patient and feels its just scar tissue build up but Im starting to have my doubts. Im just not happy and still have embarrassment when I remove my shirt. Options on what I should do next. Thanks.

Doctor Answers 3

Post-Operative Puffy Nipples

Men who suffer from large areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue. 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.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.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

6 months post gynecomastia surgery concerns; options on what I should do next?

I'm sorry to hear about your concerns after gynecomastia surgery. After carefully reviewing your before/after photographs, I think that you have a very nice change but I can also understand your ongoing concerns. I would suggest that you communicate your concerns directly with your plastic surgeon in front of a full-length mirror.  
Given that part of the issue may be ongoing "redundant" skin around the nipple/areola complexes, I would agree that ongoing time/patience may be in your best interests. For example, you may wish to evaluate the  appearance of your chest wall one year after the procedure was performed; if at that point, you continue to have the same concerns, then  additional surgery may be indicated. For example, additional tissue/adipose tissue removal plus/minus areola reduction surgery may be helpful ( again much will depend on what your communicated concerns are at that point).   Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Missed Breast Tissue Can Cause Puffy Nipples

You look like you have a great result in the second photo, considering your pre-op condition.  In the last photo, you have a typical accumulation of excess stretch damaged skin, but your areolar size is much improved from  pre-op .  Sometimes, this extra skin and subcutaneous tissue can lead one to think that they still have residual gynecomastia.  It is possible that there is some additional breast tissue left over after your surgery, however, if your surgeon suggests that you wait longer, then that is what I would suggest as well.  Your only other option is to get a 2nd opinion from another surgeon who is certified by the American Board of Plastic Surgery.
Good luck!

David F. Pratt, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 41 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.