Gynecomastia Forum

1 month after surgery and nipples still puffy

1 month after surgery and nipples still puffy
« on: May 12, 2011, 04:28:03 am »
Hello, my name is Diego and I am from Brazil.

I had gynecomastia surgery + lipo a month ago (I only had puffy nipples).

My left nipple, which was the bigger one, is a lot less puffy than before. However, the right nipple, which was not as puffy as the left one, is still puffy.

My doctor said the results were great, and that the nipples were normal.

But, for me, the right one is still puffy.
Today I told him what could we do if the right nipple remained puffy.

He said: Dont think about it, theres nothing more there. If we take anything out , a crater deformaty may occur.

Should I worry about it?

Its been only 1 month, but Im kinda affraid that I may need a revision.

Pics from chest (1 month):




Here are some pics of the right nipple (1 month):




















Linkback: https://www.gynecomastia.org/smf/index.php?topic=23198.0

Re: 1 month after surgery and nipples still puffy
« Reply #1 on: May 12, 2011, 10:05:45 am »
Yes, there is a difference between the two nipples.  Otherwise, for one month, you seem to be healing quite well.

The problem may be only swelling -- or perhaps some early scar tissue.  Would be patient and allow for everything to heal (4-6 months) and then re-evaluate with your surgeon.

Sometimes revision surgery is necessary and sometimes, perhaps, only an injection of cortisone to diminish any scar tissue.

You did not post any pre-op photos, so we cannot tell how large you were initially or if there was some asymmetry of the nipples beforehand.

Dr Jacobs
Elliot W. Jacobs, MD, FACS
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
815 Park Avenue
New York, New York 10021
Telephone:  (212) 570-6080
Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.com/revi

DrBermant

Re: 1 month after surgery and nipples still puffy
« Reply #2 on: May 12, 2011, 12:47:05 pm »
Hello, my name is Diego and I am from Brazil.

I had gynecomastia surgery + lipo a month ago (I only had puffy nipples).

My left nipple, which was the bigger one, is a lot less puffy than before. However, the right nipple, which was not as puffy as the left one, is still puffy.

My doctor said the results were great, and that the nipples were normal.

But, for me, the right one is still puffy.
Today I told him what could we do if the right nipple remained puffy.

He said: Dont think about it, theres nothing more there. If we take anything out , a crater deformaty may occur.

Should I worry about it?

Its been only 1 month, but Im kinda affraid that I may need a revision.

Looks like another Puffy Nipple Complication after gynecomastia surgery. A Crater Deformity is a phrase I coined after seeing horrible holes in chests after bad gynecomastia surgery done elsewhere. I also coined the Puffy Nipple Complication after seeing so many unhappy patients coming to me with residual tissues left behind by other surgeons. With both problems, I posted a number of examples, diagrammed mechanisms of the problem, and then showed surgical solutions. In a recent review of unhappy patients asking for help after surgery done elsewhere, there were more than 500 requests over a few years of cases reviewed. So many that it has been difficult trying to incorporate a series of additional web pages to show a representative collection of the issues and concerns.

No you do not need to leave such deforming tissues behind to not get a crater. I have many such examples on my site where I targeted the gland and have yet to have a crater from my techniques. That remaining tissue can often be removed and dealt with as long as the surrounding resources have not been depleted. I also added an example of a crater defect I did have enough tissues to revise until that patient saw a closer doctor for convenience who then removed those resources leaving an animation deformity that you should really see the movie to see just how bad a result can look.

At one month, the deformity is most likely residual tissue but it could be still swelling. Some surgeons' methods leave so much swelling that it can take months to resolve. That is why I wait a minimum of about 6 months before I offer revision surgery. This brings up a critical point, it is not just how the before and after surgery pictures look, it is also the path the tissue needs to take to get there. Looking for what any one particular surgeon's methods are like in that process can be quite revealing. The more destructive and damaging a method is, the more swelling and bruising.

I personally do not like such swelling and prefer techniques that have peak swelling on the operating table. I do not finish a case until I have a contour that I like.  The progression of swelling  and bruising seen on my website is typical for my patients. Over the years with critical documentation of the progression of my patients' tissues, I evolved my techniques such that peak swelling occurs on the operating table. I just do not see such swelling issues for my sculpture of my typical patient.

Check out my Standard Pictures for After Gynecomastia and even better Standard Videos for Male chest to better document the issues present now to better be able to document their current state and see what happens over time. If they evolve over time and improve, you have a surgical technique causing that much swelling. If they remain stable over time, there is the Residual Puffy Nipple Deformity. Be careful of selecting a surgeon for such revision. Revision surgery is an art form and looking for animation results is the best way to judge just what a doctor's methods are like.

Hope this helps,

Michael Bermant, M.D.

Re: 1 month after surgery and nipples still puffy
« Reply #3 on: May 12, 2011, 04:24:41 pm »

Check out my Standard Pictures for After Gynecomastia and even better Standard Videos for Male chest to better document the issues present now to better be able to document their current state and see what happens over time. If they evolve over time and improve, you have a surgical technique causing that much swelling. If they remain stable over time, there is the Residual Puffy Nipple Deformity. Be careful of selecting a surgeon for such revision. Revision surgery is an art form and looking for animation results is the best way to judge just what a doctor's methods are like.

Hope this helps,

Michael Bermant, M.D.

I have already checked it. Ive been checking your site for days since I notticed the puffiness.

Yes, there is a difference between the two nipples.  Otherwise, for one month, you seem to be healing quite well.

The problem may be only swelling -- or perhaps some early scar tissue.  Would be patient and allow for everything to heal (4-6 months) and then re-evaluate with your surgeon.


Well, I will then wait this period of time and then I will check it myself and then I will come here and post some pics again.

Here are some pre-op pics:



Left Nipple (Was bigger and know is a lot better)

Right Nipple (Was not as big as the left one but has not decreased as did the left nipple)





Re: 1 month after surgery and nipples still puffy
« Reply #4 on: May 12, 2011, 05:06:36 pm »
You did have puffy nipples prior to surgery, larger on the left than the right.

As previously stated, the left one looks very good -- the right one might still be slightly larger.

I would recommend you have some trust in your surgeon and give the results adequate time to heal and settle down.  It is not always residual tissue that can cause some minor elevation of the nipple.

Patience -- and then assess.  Speak to your surgeon as well.

Dr Jacobs


DrBermant

Re: 1 month after surgery and nipples still puffy
« Reply #5 on: May 12, 2011, 05:36:31 pm »

Check out my Standard Pictures for After Gynecomastia and even better Standard Videos for Male chest to better document the issues present now to better be able to document their current state and see what happens over time. If they evolve over time and improve, you have a surgical technique causing that much swelling. If they remain stable over time, there is the Residual Puffy Nipple Deformity. Be careful of selecting a surgeon for such revision. Revision surgery is an art form and looking for animation results is the best way to judge just what a doctor's methods are like.

Hope this helps,

Michael Bermant, M.D.

I have already checked it. Ive been checking your site for days since I notticed the puffiness.


Well, I will then wait this period of time and then I will check it myself and then I will come here and post some pics again.

Why not match the before surgery pictures with the same views after surgery. Non-standard views and different angles before and after surgery comparisons can be deceptive. Include in the after surgery set the additional flexing views to compare for frontal, oblique, and lateral (side), for a more precise documentation of current contour issues. Swelling or residual tissue left behind, either way, something better documented in my opinion in determining future options. That is what I used to learn how to make my patients' contours better and improve my techniques over the years.

Hope this helps,

Michael Bermant, M.D.

Re: 1 month after surgery and nipples still puffy
« Reply #6 on: May 13, 2011, 03:32:39 am »

I would recommend you have some trust in your surgeon and give the results adequate time to heal and settle down.  It is not always residual tissue that can cause some minor elevation of the nipple.

Patience -- and then assess.  Speak to your surgeon as well.

Dr Jacobs


Well, I will wait 4-6 months to see if the puffiness goes away.

I did talk to my surgeon on wednesday but he kept saying that the nipples were normal... That really pissed me off...


Check out my Standard Pictures for After Gynecomastia and even better Standard Videos for Male chest to better document the issues present now to better be able to document their current state and see what happens over time. If they evolve over time and improve, you have a surgical technique causing that much swelling. If they remain stable over time, there is the Residual Puffy Nipple Deformity. Be careful of selecting a surgeon for such revision. Revision surgery is an art form and looking for animation results is the best way to judge just what a doctor's methods are like.

Hope this helps,

Michael Bermant, M.D.

I have already checked it. Ive been checking your site for days since I notticed the puffiness.


Well, I will then wait this period of time and then I will check it myself and then I will come here and post some pics again.

Why not match the before surgery pictures with the same views after surgery.


Good point. After 4-6 months I will ask his secretary to take some photos and then I will come back here and post them.

DrBermant

Re: 1 month after surgery and nipples still puffy
« Reply #7 on: May 15, 2011, 06:11:53 pm »
Well, I will wait 4-6 months to see if the puffiness goes away.

I did talk to my surgeon on wednesday but he kept saying that the nipples were normal... That really pissed me off...


Check out my Standard Pictures for After Gynecomastia and even better Standard Videos for Male chest to better document the issues present now to better be able to document their current state and see what happens over time. If they evolve over time and improve, you have a surgical technique causing that much swelling. If they remain stable over time, there is the Residual Puffy Nipple Deformity. Be careful of selecting a surgeon for such revision. Revision surgery is an art form and looking for animation results is the best way to judge just what a doctor's methods are like.

Hope this helps,

Michael Bermant, M.D.

I have already checked it. Ive been checking your site for days since I notticed the puffiness.


Well, I will then wait this period of time and then I will check it myself and then I will come here and post some pics again.

Why not match the before surgery pictures with the same views after surgery.


Good point. After 4-6 months I will ask his secretary to take some photos and then I will come back here and post them.

My suggestion was to document the issue now. Having the documentation can be proof of what the contour is like at this point in time. No change over time is best known with documentation not just guessing. The more complete set would also prove if there are significant contour issues that certainly seem to be there at this point. It is the strange way the new pictures are taken that can distort issues.

Hope this helps,

Michael Bermant, M.D.


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