here are some 10 weeks pos op pics

and some more

It is difficult to determine whether you have residual gland under the nipples (which may not have been totally removed at the time of surgery) or have developed scar tissue under the areolas.  The best person to answer your question is your surgeon, who knows exactly what was done and what it looked like at the end of surgery on the operating table.

Be patient and return to your surgeon with this question.

Dr Jacobs

There is certainly no harm in waiting and trying massage -- time will tell.

Dr Jacobs

I think you've come a long way and have a very nice result so far. I'm not sure if you are describing some scar tissue beneath the nipple or if it is actually the areola that you are having an issue with. One thing that I see is that before surgery your areola was very stretched out. As your entire breast skin is now shrinking there is contraction of the areola. This is causing some "thickening" of the areola which is adding some "puffiness". It is still too early to do anything but if tis is the ase, and should it continue to bother you, it would need some removal of the areola. Hopefully you'll be happy when your healing is complete. Give it another few months.

Thanks for the follow up. I can't recall how long it has been since your surgery. In general I think that most of the healing should be done by 3 months after surgery, though the return of full feeling can certainly take longer. I understand what you are concerned about. Without an exam it is difficult to tell if there is residual tissue beneath the nipple or if the problem is due to having a very "soft" areola. It also looks like you may have some general skin laxity that would prevent your skin from shrinking optimally. hang in there an follow your surgeon's instructions and keep the lines of communication open. Good luck.

I would echo Drs. Jacobs and Schuster with regard to your  results. You are well on your way to a good final outcome.  The "soft" areolae are common in patients who have a large distended areola pre-operatively, and I sometimes caution patients with regard to how this may look post-operatively, since these areolae tend to be wrinkled or creased looking on occasion, and in a few cases, I've performed areola reduction secondarily under local anesthesia after six months to a year, if the areola is still puffy or big looking.  In some cases, the persistent puffiness is related to swelling and scarring, and in those cases, Kenalog leads to rapid improvement most of the time.  If it's the skin of the areola, less improvement will be gained by the injection.
Rick Silverman

I've been trying to be as patience as i can. So far it's been 4 month and 1 week since surgery. Since my last post op pictures there has been no mayor change. Both nipple are still puffing out even when i lay down, and you can see both of them through t-shirts. Also I can still feel a pretty hard mass under both areolas. Both nipple still hurt a bit when i apply pressure to them.

I finally got an appointment to check my situation with my physician this friday to ask him what he thinks about this situation and what we should do next. I'll be posting here what he says to me in order to get some others opinions.

Thanks!

I had my appointment with my physician yesterday. I asked him about my situation and he suggested to wait a little more. Its been 4 moths and 10 days since surgery, so we decided to meet again in 2 or 3 months more, when i have reached 6 month post op. Then, we will evaluate the results in order to decide whether we use some kenalog injections or not.
I'm really curious about what could happen if you get kenalog injection and there is no scar tissue under your nipples but if gland. 
So i'll be posting some new information and pictures soon.

Sounds like a good reasonable approach. Good luck.

Without knowing the actual dimensions of the small remnant that was left behind under the nipple areolar complex, it's impossible to know if the persistent lumps are related to scar tissue or persistent gynecagmstai.  If it's scar tissue, the kenalog may help with regression of the scar tissue and flattening of the lumps.  If it's gynecomastia tissue, it's likely that only additional resection will help.