Insufficient gland excision after gynecomastia surgery? (Photos)

Question

I had surgery about five months ago to correct some mild gyno – but I think I still have some residual tissue. My surgeon insists there's no more gland, but I can feel something hard behind my nipple. My chest sags when I bend over, too. Is it merely swelling, or do I need the excess gland removed?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question about male breast reduction, gynecomastia, chest sculpting, and possible need for gynecomastia revision. Since you are only five months after your gynecomastia surgery, it is too early to tell.  I would suggest you wait a full twelve months after your gynecomastia surgery.  The hardness you feel behind the nipple is probably residual scar tissue.  At one year, I would re-evaluate the nipple hardness.  If the hardness is still there, you and your plastic surgeon may want to consider further surgery. If there is residual scar or breast tissue, you may be a candidate for liposuction.  If it is dense scar tissue, you may need a formal breast scar tissue resection.  This would involve an incision and removal the hard tissue.  On another note, you mention, your chest sags when you bend over.  This means you have excess male breast skin tissue.  If you truly have excess breast skin, you may need one of two breast surgeries, namely male breast VASER liposuction or male.  Male breast VASER liposuction is optimal because the VASER heats the undersides of the breast skin and causes skin contracture and tightening. Alternatively, if you have a significant amount of male breast skin you may require male breast skin removal with an incision around the nipple or under the breast fold or infra-mammary fold.  Good luck!  I hope this answered your question regarding possible male breast revision surgery for gynecomastia and possibly excess male chest skin.  If you have any other questions regarding male breast reduction, gynecomastia, and chest sculpting, please contact my office.  Sincerely, Dr. J. Timothy Katzen

Jeffrey Umansky, MD · Answer

Thanks for your question and photos.  It is difficult to say exactly what is happening without an exam.  If you are not satisfied with your results, you should return to your surgeon.  Most surgeons want their patients to be happy and will perform touch ups if necessary.  Good luck!

Jayanthy Ravindran, MS, DNB, MRCS · Answer

Thank you for opening up this question. Gynecomastia surgery is a less painful and permanent result oriented procedure that will require you to allow at least 6 months for recovery and allow the consultant to pass evaluations before the final outcome of the procedure. Follow-up treatment will of course vary depending on the diagnosis.

Swelling is the most common side effect that you might encounter after your gynecomastia procedure and during the healing process. I suggest that you wait a little longer for the area to be completely healed before jumping to conclusions. There are many ways in which the healing process takes place and in nearly every situation, your body will completely recover within one year after the procedure, but again it depends on the body type that determines how soon you generally recover. Now that it's been just five months out of the procedure, it is too soon to be expecting a complete recovery. However, following the strict post surgical instructions given by your aesthetician can help speed up the recovery process.

The hardness that is felt behind the nipple is possibly the residual scar tissue from the surgery. It's always advisable to re-evaluate the nipples after one year.  If the hardness still persists, your  aesthetician and you might want to consider going for another diagnosis and treatment. If it happens to be a breast tissue or residual scar, you may be suggested another liposuction.  If the scar tissue is dense, you will need a scar tissue resection. This procedure involves an incision and removal of the hard tissue. Although there are chances for an insufficient gland excision, it can only be determined in a face to face appointment.

Sean Doherty, MD, FACS · Answer

Based on your photos, it does not look as if you have excess glandular tissue. I would suggest that you seek a second opinion from another board certified plastic surgeon who can examine you in person. Best of luck.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after gynecomastia surgery. Your surgeon will always be your best resource for accurate diagnosis, advice, and/or meaningful reassurance.   It will be your best interest to allow for at least 6 months to pass before evaluating the final outcome of the procedure performed.  At that point, it will be possible to determine whether  any residual "mass" is related to residual breast tissue or maturing scar tissue.  Treatment of course will vary depending on this diagnosis.  Again, key will be close follow-up with your surgeon and ongoing patience. Best wishes.

Karthik Ram, MRCS, DNB · Answer

Hi , Thanks for the enquiry.Even after complete removal of the gland ,Sometimes Scar tissue forms underneath the areola.It respond well to triamcinolone steroid injection in the scar tissue . It might be helpful in your case . Discuss with a board certified plastic surgeon and take a call

Beverly Friedlander, MD · Answer

Hi,Thank you for your question and your photos. Five months is usually sufficient time for healing.   It appears on several photos that the nipple areola may be minimally depressed.  This is an indication that you probably do not have much if any residual gland.  I would suggest a 2nd opinion with a face to face consultation and examination  with a local plastic surgeon  to confirm this and to help identify the "hard" something you feel.Good Luck,  Beverly Friedlander, MD

Insufficient gland excision after gynecomastia surgery? (Photos)

Answers (7)

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