Seems to Still Have Plenty of Fat Behind Nipple 5 Weeks Post Surgery. (photo)

This is now going on 5 weeks Post Surgery. 0 swelling, Im back to being 110% active and it feels like I never had gynecomastia surgery. I feel that the nipple is suppose to lay flat/flush on the chest muscle. Does this seem like a situation where I will need additional surgery? Its almost as if there was no surgery done at all. I shouldnt be able to grab fat like this behind the nipple? its how it was before. Noway that will magically disappear in 2 months from now.

Doctor Answers 4

Fat vs gland vs laxity

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Thank for the photos.  In these situations the diagnosis really is about determining whether it is fat, gland, or laxity as treatment depends in part on what is causing the fullness.  If it is fat liposuction will be able to thin out the area.  If it is gland however, resection by cutting it out is recommended.  It does not appear that laxity is a big component of the problem at this time.

All the best,

Dr Remus Repta 

Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Was Enough Tissue Removed At The Time Of My Gynecomastia Surgery?

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It would be very helpful if I could see a pre-operative picture to see how much actual skin you had.  Also your age, and history of weight gain and loss would be useful as well.  I see there is an area on the lateral side of your chest where the liposuction cannula was inserted, and that is the site most of us use for liposuction male breast reduction.  It also appears there is a small incision at the bottom of the areola where some gland was surgically removed.  If that is true, then your plastic surgeon apparently made all the right maneuvers. 

Post operatively, I would use therapeutic ultrasound (the kind physical therapist use for sore muscles) on your chest to break up the organized swelling that normally occurs and hasten your recovery.  Is it possible there is still some fat left?  Of course, but it is also possible that it is just skin and subcutaneous tissue, and it needs to shrink up and may take up to 9 - 12 months for you to get a total read on things.  If there are hard areas in your male breast area, these can also judiciously be injected with a corticosteroid.  The good news is it is much too early to decide if there is any residual fat or not.  You should still be wearing a compression garment, getting ultrasound, and giving it time.  I think you will be much more satisfied with the result 3 - 4 months from now.

Swelling After Gynecomastia Surgery

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The most common complaint after gynecomastia surgery is the persistent appearance of swelling behind the nipples.In my experience, gynecomastia is a combination of soft fatty tissue and very firm glandular tissue.The fat can, and probably should, be removed with liposuction but the hard tissue needs to be surgically cut out. Either surgery causes significant normal swelling which obscures the final result and will need 6 months to settle.Whether you have soft or firm tissue left will determine what if any additional surgery will be necessary. For now, your only course is to be patient!

Bernabe Vazquez, MD
Miami Plastic Surgeon
4.8 out of 5 stars 20 reviews

Seems to Still Have Plenty of Fat Behind Nipple 5 Weeks Post Surgery.

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As seen in your posted photos I would have to agree with you that minimal change has occurred. Seek in person second opinions. Was the Smart Lipo doc a PS? Please respond. 

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.