I am 6 weeks post op following Vaser lipo: my breast now feel hard and puffy and tender to touch.

Question

I have just taken my compression garment off as per my nurse and surgeon. My breast now feel hard and puffy and tender to touch. I know it can take months to settle down just wondering what you Docs think about the results? Am i being ambitious hoping that they would be flat after the operation? One side does look bigger than the other. ( the side that had more flyid taken out) Pics attached

Jason Emer, MD · Answer

You still have swelling, which can last 3-6 months after your procedure. I recommend adding hyperbaric oxygen and lymphatic massage along with your compression to help decrease swelling. To improve your final results, I also recommend adding vanquish for further fat removal, exilis/venus legacy for skin tightening, cellutone/z wave to make the skin smooth, remove scar tissue, and improve the skin’s appearance. For chest however, its best to have fat injected into the muscle to make this area appear more athletic. Best, Dr. Emer

Jed H. Horowitz, MD, FACS · Answer

Thank you for providing photos for reference! You are correct that you should wait at least 6 months to see results and to be sure that swelling is gone or has significantly lessened. Some things you can do is to massage gently to help remove firmness and discomfort. Another option is to have a separate procedure that can be done to remove a little excess skin after several weeks to months later after skin contraction has occurred. A #revision can also be done to remove more fat if desired. If you have any more concerns, do not hesitate to contact your plastic surgeon. Best of luck!#RealSelf100

Mats Hagstrom, MD (license on probation) · Answer

Male chest liposuction often requires more aggressive treatments because of the firm nature of breast glandular tissue.
Because of this VASER is often an excellent choice.
For most liposuction surgeries results are fairly close to final at six weeks but in certain cases it can take closer to 3 to 6 months.
The changes obviously become less and less as time goes on.
Areas that are still tender typically still have inflammation and patients should expect improvement with time.
In regards to the results it's somewhat difficult to tell without an examination.
Often men will have even some skin laxity on the chest. When they have gynecomastia.
I call loose skin the enemy of liposuction.
I say this for several reasons.
First of all loose skin often looks like excess of subcutaneous fat to patients. Since The skin is also not treated by liposuction the patients The results can sometimes be less impressive than patients with very tight skin.
One accurate way to assess how thick your subcutaneous fat is either before or after the procedure is to take your arm and structured way behind your head pulling the skin chest as tight as possible.
With your other hand look in the mirror and press on your skin until you feel the muscle layer.
For patients with some skin laxity I often will over treat slightly to compensate for their skin laxity.
For the sake of argument you are probably still swollen and your results will improve in which case I would say your results are good.
It's very important to understand which patients are candidates for having great results and which ones are not.
Patients who are not good candidates for getting ideal results need to have expectations set accordingly.
Again, this usually has to do with skin laxity.
In the case of gynecomastia in certain patients it can be difficult to sufficiently remove enough firm glandular tissue to get an idea result in which case a small incision can be made to directly cut out the glandular tissue.
With the use of it VASER this is usually not needed.
Give it a few more months.
Wouldn't be a bad idea to follow up with your plastic surgeon to have him make sure there isn't anything like a fluid buildup though it does not appear so from what you described.
Best,
Mats Hagstrom M.D.

Amit Gupta, MD - Account Suspended · Answer

hello. at six weeks post op the presistance of swelling is very normal particularly with VASER, which causes more intense inflammation than conventional lipo. having said that, i feel a little bit more fat could have been removed. There appears to be some fat/seromas, which are difficult to asssess on pics. numbness, paresthesia till 6 months is very common. 
Regards

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