Will skin retract post op?

Will skin retract post op?
« on: February 12, 2012, 12:12:30 pm »
Hey everyone, I'm hoping someone here will be able to help me with my concern. I'm 20 and I just had my surgery 8 days ago to get rid of my puffy nipples. I have a prominent muscular chest but it looks nearly identical to the way it did pre-op. There's definitely an improvement as far the contour towards my nipple on the sides of my pecs where i can tell that the tissue is gone. However, it still feels like the skin is very loose and my nipples are exactly the same size they were before. Obviously, there is alot of swelling and fluid but what I am wondering is:

-Will the nipples retract over time into an ideal size or will my nipples always be large? I have read some stories where the patients areola's immediately shrink after the tissue is removed. Is it possible to determine if mine will also shrink with time?

-will the skin around and below my nipples eventually tighten up and reveal more definition of the lower part of my chest?

It feels as if they are deflated and i can still grab a decent amount of skin and what feels like a little bit of tissue he left underneath. I'm really worried about the healing and if the skin is going to reattach and tighten up against my pec. I wasn't told to wear any kind of compression but do you think i should? I have a tight under armor shirt I could wear. My dad's an ERP and he told me that it will look good once all the fluid and swelling is gone but I feel like I'm going to be left with 2 loose nips, he's also the one that told me this would go away on its own. feeling skeptical, here are some pictures.

Linkback: https://www.gynecomastia.org/smf/index.php?topic=24854.0

Re: Will skin retract post op?
« Reply #1 on: February 12, 2012, 12:24:07 pm »
I really don't know what to think, I've waited a very long time for this operation and I was really looking forward to taking my shirt off this summer. Do you think that once the fluid and swelling subsides that increased upper body training could improve the loose skin and lower definition issue should it persist?

Re: Will skin retract post op?
« Reply #2 on: February 12, 2012, 12:56:20 pm »
i read in another post somewhere that the guys were saying the compression vests should help in allowing the skin to tighten up. i would wear one if i were you. it wouldn't hurt to try. also try massaging your chest to move the fluid around? i havnt had my surgery yet so I'm deff no pro at this but I'm sure you'll turn out fine!

Re: Will skin retract post op?
« Reply #3 on: February 12, 2012, 07:33:33 pm »
Did he perform excision of the glandular tissue through the nipple or just lipo?

Re: Will skin retract post op?
« Reply #4 on: February 12, 2012, 10:42:17 pm »
excision of gland

Offline jb123

Re: Will skin retract post op?
« Reply #5 on: February 13, 2012, 01:34:58 am »
Did it look exactly like that before surgery?

That is weird. I just had the same surgery but haven't taken my tapes off yet so I'm not sure exactly how my nipples will look.

You weren't told to wear any kind of compression garment after surgery?

Re: Will skin retract post op?
« Reply #6 on: February 13, 2012, 02:29:59 am »
One of the problems in doing excision alone is that the surrounding skin is untouched.  Hence the nipple skin, even with the tissue beneath it having been removed, has nowhere to go -- so it can remain puffy.  That is why I always insist on performing lipo (even without suction) with gland excision -- that is the only way the surrounding skin can re-drape and redistribute. 

You should find out from your surgeon if he did any lipo on the surrounding areas as well -- it can go a long way to allaying or confirming your concern.

Dr Jacobs
Dr. Jacobs 
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

Re: Will skin retract post op?
« Reply #7 on: February 13, 2012, 08:56:38 am »
If he did perform lipo would the results be obviously different from this or does the skin look like this for a while post-op then gradually shrink and re-drape as the swelling and fluids dissipate? in my case how much of the skin around the nipple would you typically separate from the muscle with lipo? i feel like there would be obvious bruising on my chest if he had done that. I'm only on day 8. I just want to know if i'm going to have to do a revision surgery if he neglected the lipo.

Re: Will skin retract post op?
« Reply #8 on: February 13, 2012, 12:41:41 pm »
Sorry, but there is no way for me to answer your question -- but there is nothing to do right now except to wait it out.  Compression garments are always helpful.  A conversation with your surgeon may help to provide answers for you.

You are in the very active stage of recovery and healing.  Give it time (up to six months)for everything to heal before even considering revision.

Good luck!

Dr Jacobs

Re: Will skin retract post op?
« Reply #9 on: February 18, 2012, 02:03:15 am »
I understand and thank you very much for your help! Just one more question regarding your own personal experience. Obviously every case is different, but from what you have seen in cases similar to mine, where the nipples remain puffy post op, have your own patients come to you with the same concerns i have? and have they seen results after waiting it out? I'm very lean and had a significant amount of gland tissue removed so i feel as if i will always have excess skin there. If I pull my skin and nipple up slightly with my hand i can see very clearly the perfect contour of my lower pec which wasn't really possible before surgery, but when i release the skin falls back down again and looks bad. because of the absence of the gland, is it possible for my skin to eventually change shape and shrink to my chest? I know I am reiterating myself with this question but I am not asking you to tell me what will happen to myself specifically, I'm only wondering what you have seen happen to your own patients of similar body type and situation. My main concern isn't whether or not my nipples remain puffy but more so that all the excess skin that has been stretched for years by my gland reduces. I feel like I am so close but I'm Still very worried that i may have to do a skin reduction or something extreme to achieve the ideal contour if the healing process doesn't yield these results. your wisdom is greatly appreciated as always.

Re: Will skin retract post op?
« Reply #10 on: February 18, 2012, 12:49:42 pm »
I have not seen this problem in my patients because I use lipo, in one form or another, with every case.

Given the fact that you are young, your skin by definition has a lot of elasticity.  That is why "watchful waiting" is your best answer at the moment.

At six months or so, if the condition has not significantly improved, then consideration should be given to a revision with lipo, NOT an areolar reduction (which would result in circumferential scarring around the areola and eventual re-stretching of the areola.

Dr Jacobs

Offline jb123

Re: Will skin retract post op?
« Reply #11 on: February 18, 2012, 06:53:30 pm »
Where were your incisions made?

Offline ap123

Re: Will skin retract post op?
« Reply #12 on: February 19, 2012, 08:16:52 am »
Just a question I have been wondering about. So I had the surgery 5 days ago. And my nipples are kind of in the same situation as yours. They look puffy but probably because of the swelling and what not. So I was wondering if icing the nipples would help the swelling go down??? Because I know if you get  a bruise or fat lip or anything like that icing it helps. Any suggestions/opinions?

Re: Will skin retract post op?
« Reply #13 on: February 19, 2012, 05:08:51 pm »
Would definitely not ice the nipples.  Oftentimes if surgery has been done under the areolas, the blood supply is slightly diminished to the tissues.  If you then apply ice and further constrict the blood vessels, you may deprive the areolar skin of blood and there may be dire consequences.

At 5 days you are at the barest beginning of the healing process -- do not be so impatient!

Dr Jacobs

Offline jb123

Re: Will skin retract post op?
« Reply #14 on: February 19, 2012, 06:01:06 pm »
Did you guys have incisions below the nipples or around the bottom of the nipple?

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