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25 days post up with concern over possible poor skin adhesion! +video

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Hello,
 I had full gynecomastia surgery 25 days ago involving gland excision and liposuction.
I have a concern about the area of skin below my right nipple. It appears somewhat fleshy and loose, especially when compared to the left side. The scar tissue in this effected area has really broken down in the last week and I am wondering if what I'm left with is skin that did not properly adhere to the muscle beneath? The area is not squidgy as other fluid filled patches have been on previous locations.

I have made a useful video of me palpating both sides of my chest for your reference.

please copy and paste url below to view.
(direct linking disabled, if site doesn't load try adding http:// infront of url)

s1081.photobucket.com/albums/j344/isambard1/?action=view&current=rightchestfleshy.mp4


Some background information::

-Intraoperative and Postoperative periods were uneventful.
 
-I have been using a compression garment supplied by surgeon continually with a few exceptions.
   (About 5 and 6 days following surgery I wore an underworks compression vest that did not provide similarly snug compression. I wore this for several hours both days. I switched back to the old compression garment because it seems to provide tighter compression. However it seems to compress one side more than the other. The left side received more compression than the right.)

-between days 11-14 I spent 2 hours a day not wearing any compression garment.(massaging/showering etc)

- I always slept with snug compression garment on

-between day 20-25 I have noticed a fuller fleshier appearance to the area below my right nipple.

Your insights are much appreciated.

-Isambard-


Linkback: https://www.gynecomastia.org/smf/index.php?topic=24460.0

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Offline Litlriki

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Re: 25 days post up with concern over possible poor skin adhesion! +video
« Reply #1 on: November 29, 2011, 05:38:21 AM »
It's difficult to tell from the video that there's much of a difference.  If it feels boggy, there may be some fluid in there, and your surgeon should be able to determine that and drain it very easily.  There aren't many other things that would cause the skin to remain loose, especially if you're wearing compression--even most of the time.

Time to see your surgeon.

Good luck,

Rick Silverman
Dr. Silverman, M.D.
Cosmetic and Reconstructive Plastic Surgery
29 Crafts Street
Suite 370
Newton, MA 02458
617-965-9500
800-785-7860
www.ricksilverman.com
www.gynecomastia-boston.com
rick@ricksilverman.com

Certified by the American Board of Plastic Surgery

Re: post up with concern over possible poor skin adhesion! +video
« Reply #2 on: January 21, 2012, 03:41:37 PM »
Thank you Dr. Silverman for your reply. Apologies for the delayed response.

I am now 11 weeks post op and continue to have this concern. The problem is now more noticable and has begun to affect my left breast. In the previous response I was advised to see my surgeon but that has not been possible because the surgery was done in a foreign clinic. I will send these pictures and chase the surgeon for a phone consultation soon but any alternative professional opinions will be most welcome here.

Essentially I still have puffiness and fullness that is felt on palpation. It isn't always visible when I have an upright posture but can be seen when I lean forward, especially in 3/4 profile or from above. I have tried to show this in the pictures below. I also have slight indentation of the nipples but that is not a concern right now as I am massaging and it's getting better.

My thoughts on what it could be are:
1)Poor skin re-adhesion to the fat and connective tissue beneath the skin following liposuction. I did wear my compression garment most of the time for over 4 weeks but the left breast received slightly more compression due to the construction of the compression garment. Could this have been enough to cause a void that is now being filled in with fat?! or is it still fluid. would I benefit from trying to drain it?

2)another theory is that the fat in this area was not sufficiently liposuctioned out. Thus creating an uneven distribution of fat with more fat below my nipple than above it. Having said that, my surgeon has a good reputation and I doubt that she would have made this mistake.

To any doctor reading this, please let me know what you make of this. Could it sort itself out, for instance if it's fat and I loose some weight?
Your professional opinions are most appreciated. thanks.

VIDEO FROM DECEMBER AGAIN:
s1081.photobucket.com/albums/j344/isambard1/?action=view&current=rightchestfleshy.mp4




OK with upright posture but still noticeable on palpation:

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Offline Litlriki

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Re: 25 days post up with concern over possible poor skin adhesion! +video
« Reply #3 on: January 22, 2012, 07:25:47 PM »
It's very difficult to make any real assessment from the photos.  If anything, your second option is possible, as the liposuction portion can leave some fat behind, even in the best of hands.  We all caution our patients that touch-up procedures might be needed, but that won't be decided before at least six months, if not longer, to allow for the healing to progress.  It's not possible to determine if there's a seroma from these photos.  You'll probably need to see a surgeon closer to home to take a look, unless your primary care doctor is comfortable examining you.

RS