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How Long Until Nipples Flatten Post Op?

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How Long Until Nipples Flatten Post Op?
« on: August 24, 2009, 05:56:02 PM »
Hey guys. I had surgery on the 4th of August. My surgeon removed a decent amount of gland and 300ccs of fat from each side. I was extremely happy with the results (and still am). My scar tissue has developed, and yes, unfortunately I noticed my left nipple (more than my right) has slightly poofed. My surgeon resized my nipples, which I believe is limiting the poofyness, but I'm not really worried. Everyone says that everything will work out as long as I stay patient. I can still wear whatever I want with the poofyness and it doesn't show, so I'm extremely thankful :)

However, my few questions are this:

My surgeon told me that I can do anything after 3 weeks post op. Maybe it's due to my age (18), that my surgeon thinks I can recover faster? I ran a little today and I didn't feel any issues; however, I was wearing my vest when I ran so maybe that had something to do with not feeling pain (as my chest wouldn't really be bouncing).

Question Two: My nipples are both inverted. They were like this pre-op but I hoped that they would become normal after surgery. They're still inverted. Will this fix itself? Also, my surgeon seems to have slightly fumbled with his incision on my right side, and he kinda went through the bottom half of the nipple a little bit. What's that gonna look like in the long run?

EDIT: Question Three: I also have an indentation on my left side. At first I thought the doctor may have removed too much gland (which actually he may have...who knows) but the dent is on the side of the nipple, not where the gland was. Also, my surgeon seemed to have done a better job liposuctioning the right side; the left side has more fat left in it. Will there always be an uneven ratio of fat in my chest now, or can I burn that fat off?

Thanks for any and all help.

-James

Linkback: https://www.gynecomastia.org/smf/index.php?topic=18849.0

Re: 3 Weeks Post Op with a Few Questions
« Reply #1 on: August 25, 2009, 10:02:55 AM »
All your concerns are relevant -- but it is just too early in the healing phase to make any definitive judgments.  It is understandable that you would study the results of the surgery -- and yet everything is healing and evolving and in constant change.

Best advice is to sit back, relax and let Mother Nature take its course.  Even if something is needed to be done -- this is not the time to do it.

Best advice is to discuss this with your surgeon about several months after surgery -- when the majority of the healing has occurred.

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

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DrBermant

Re: 3 Weeks Post Op with a Few Questions
« Reply #2 on: August 26, 2009, 08:10:26 AM »
Hey guys. I had surgery on the 4th of August. My surgeon removed a decent amount of gland and 300ccs of fat from each side. I was extremely happy with the results (and still am). My scar tissue has developed, and yes, unfortunately I noticed my left nipple (more than my right) has slightly poofed. My surgeon resized my nipples, which I believe is limiting the poofyness, but I'm not really worried. Everyone says that everything will work out as long as I stay patient. I can still wear whatever I want with the poofyness and it doesn't show, so I'm extremely thankful :)

However, my few questions are this:

My surgeon told me that I can do anything after 3 weeks post op. Maybe it's due to my age (18), that my surgeon thinks I can recover faster? I ran a little today and I didn't feel any issues; however, I was wearing my vest when I ran so maybe that had something to do with not feeling pain (as my chest wouldn't really be bouncing).

After Gynecomastia Surgery Chest Compression can help support healing tissues and minimize swelling. Patients are typically able to do more with such support after surgery.

Real healing just does not work on a specific schedule.  You have had cuts before. Do they all heal at the same rate? Do you really believe that someone can give you a specific time for return to activities.  Each individual and each wound is different.  Pushing healing tissues too soon will result in more damage, swelling is a result of damaged tissues being unhappy and or being further damaged.  For optimal healing, peak swelling should be at the time of the injury (the operation). For doctors who are more cavalier with their after surgery care instructions, patients will have secondary swelling and possibly delayed healing.  Surgery of the male chest recovery is like having a sprain of the muscles.  Tissues need time to heal before they are stressed.  In bodybuilding no pain, no gain.  In healing, ignore the pain and you will screw the gain. 

Question Two: My nipples are both inverted. They were like this pre-op but I hoped that they would become normal after surgery. They're still inverted. Will this fix itself? Also, my surgeon seems to have slightly fumbled with his incision on my right side, and he kinda went through the bottom half of the nipple a little bit. What's that gonna look like in the long run?

Male Inverted Nipples can be a factor when the gland of gynecomastia tethers the nipple to deeper structures. Unless the doctor designs the surgery to address this tethering, the deformity will remain after the operation.  Sometimes Revision Gynecomastia Surgery can help.

Question Three: I also have an indentation on my left side. At first I thought the doctor may have removed too much gland (which actually he may have...who knows) but the dent is on the side of the nipple, not where the gland was. Also, my surgeon seemed to have done a better job liposuctioning the right side; the left side has more fat left in it. Will there always be an uneven ratio of fat in my chest now, or can I burn that fat off?

Thanks for any and all help.

-James

20 days is very early after surgery with some techniques.  How tissues heal after gynecomastia surgery depends on the problem to be treated, what was done, skill of the surgeon, and many other factors. I prefer to start out with a good contour as I finish each patient in the operating room. 

Tissues do tend to equilibrate over time. Posting Standard After Gynecomastia Surgery Pictures can help other better understand your concerns.  Weight loss after surgery can be unpredictable, you cannot pick where the fat comes off from.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

Re: 3 Weeks Post Op with a Few Questions
« Reply #3 on: August 27, 2009, 06:50:10 PM »
Thank you for your responses, Dr. Bermant and Dr. Jacobs.

I have one more question. I'm not sure if it's due to me removing my garment, but my nipples are slightly poofy once again. It is minimal but I feel uneasy because it shows through normal shirts. Is this due to scar tissue (which I feel is present)? I'm really hoping my nipples don't stay like this. I'm OK with it shirtless but it shows with a shirt.

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DrBermant

Re: 3 Weeks Post Op with a Few Questions
« Reply #4 on: August 30, 2009, 11:52:28 AM »
Thank you for your responses, Dr. Bermant and Dr. Jacobs.

I have one more question. I'm not sure if it's due to me removing my garment, but my nipples are slightly poofy once again. It is minimal but I feel uneasy because it shows through normal shirts. Is this due to scar tissue (which I feel is present)? I'm really hoping my nipples don't stay like this. I'm OK with it shirtless but it shows with a shirt.

Firm tissues after surgery can be residual gland, but also can just be healing tissues or scars.  Different surgical techniques injure tissues to different degrees. Time to tissues softening can vary depending on the original problem, what was done, after surgery care,
Scar Care, After Surgery Compression Garments, and many other factors. Options depend on the problem to be treated. Time can range from 6 months to a year but can vary depending on many issues best explored with your doctor.

I see many patients who complain of residual Puffy Nipple Gynecomastia after another doctor's surgery.  There are many possible problems causing such a deformity.  The most common is remaining gland behind the areola as seen in these Anatomy of Puffy Nipple Drawings.  Check out the images with the link for remaining gland after surgery to see what I mean. 

Liposuction is great for fat, but does not do well for gland at all.  As shown in the anatomy link, there are usually fingers of gland between fingers of fat.  Liposuction no matter what technique (sharp cutting cannula, specially designed cannula, ultrasonic, laser, or "smart") targets the fat first.  Remove the fat and the gland remains behind condensing the fingers making a firm mass.
 
Even if the doctor achieves a flatter chest, that firm mass does not look like fat, move like fat, or compress like fat.  It just does not move well or look good (especially on animation).  That is why few doctors will show results with chest muscles tightened or arms up over the head or movies showing the tissues in motion.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia Surgery

Re: 3 Weeks Post Op with a Few Questions
« Reply #5 on: September 02, 2009, 09:17:24 PM »
Dr. Bermant, my doctor excised gland (what appeared to be a LOT, maybe two ping pong balls alongside each other) and did 300CCs of lipo on each side. What I'm feeling doesn't feel anything like gland. Should I still be worried? I"m only a month post op.

Re: 3 Weeks Post Op with a Few Questions
« Reply #6 on: September 03, 2009, 02:42:31 AM »
Dr. Bermant, my doctor excised gland (what appeared to be a LOT, maybe two ping pong balls alongside each other) and did 300CCs of lipo on each side. What I'm feeling doesn't feel anything like gland. Should I still be worried? I"m only a month post op.

I have the same problem. Again puffy nipples after surgery. They say scar tissue causes this.
Most people advise to wait it out for 3-6 months and see if the puffiness goes away (slowly). If not, talk to your surgeon.
Might be gland left over, but probably scar tissue.
It's a common problem. Lots of threads about it on this forum.

PS I had also lipo + excision
grtz

Re: 3 Weeks Post Op with a Few Questions
« Reply #7 on: September 03, 2009, 02:45:01 AM »
Dr. Bermant, my doctor excised gland (what appeared to be a LOT, maybe two ping pong balls alongside each other) and did 300CCs of lipo on each side. What I'm feeling doesn't feel anything like gland. Should I still be worried? I"m only a month post op.

You need to try and relax a bit to be  honest.   Final results will take a bit longer to show up, especially if you are having a lot of swelling or scar tissue forming.   Over doing it will actually make your recovery process longer; so make sure you are following the post op instructions and eating a healthy diet too. (your body needs plenty of vitamins &  minerals at this time so don't skimp on the vegetables & fruits).

In my experience each side heals slightly differently, in my case the left side seemed to take a lot longer to go completely flat than the right side.


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DrBermant

Re: 3 Weeks Post Op with a Few Questions
« Reply #8 on: September 03, 2009, 08:36:24 AM »
Dr. Bermant, my doctor excised gland (what appeared to be a LOT, maybe two ping pong balls alongside each other) and did 300CCs of lipo on each side. What I'm feeling doesn't feel anything like gland. Should I still be worried? I"m only a month post op.

Healing tissues can feel like scar or gland, touch alone is not enough to differentiate.

These are questions best directed to your doctor who is familiar with what was done, the original problem, and can examine your chest. False assurances that "everything is OK," by someone who does not have all of the specifics is just that advice without foundation.  Actually, such specific advice from any doctor can be construed as establishing a doctor patient relationship and that doctor may be liable for that advice.  That is why my answers are generalities, that is the recommended method of helping others when there is no such relationship.

If you do not trust your own doctor, then see someone else for a second opinion. We offer such second opinion assistance, but typically for revision gynecomastia surgery tissues need to further evolve.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

How Long Until Nipples Flatten Post Op?
« Reply #9 on: September 27, 2009, 12:50:05 PM »
I had my surgery on August 4th for gland removal and lipo. I had 300ccs of fat sucked from each side and the glands removed. I had poofy nipples as well as gynecomastia. I'm now nearing my 8th week post op and my nipples are still slightly poofy. The poofiness is pretty minimal, but it still slightly distorts my chest. I still have that small semicircle of scar tissue where the incisions were made, and I hear that those are what makes the nipples remain poofy? My surgeon seems to have left a little more fat in the left side, and I also notice that the left nipple is slightly poofier, but the scar tissue also feels thicker than on the right side. I'm hoping that my nipples will flatten out because right now my chest looks like a minor case of gyne, rather than a corrected case of gyne.

How long did it take for most of your nipples to flatten out (if you had poofy nips) after surgery? I think I'm also gonna start working out more consistently soon, as I was exercising consistently pre-op and basically stopped altogether post-op, because I'm concerned I may have gained between 2 or 3 pounds post-op. Two or three pounds shouldn't change very much for me, because I'm not below average height or weight (6', 175lb post op) but it's making me paranoid.

I'm sure many of you have been in my exact situation, so any help would be appreciated.

- James

Re: How Long Until Nipples Flatten Post Op?
« Reply #10 on: October 05, 2009, 08:27:25 AM »
James,

I'm in exactly the same situation as you.
I'm now just being patient and hope that nipples will flatten out in the months to come...
I had the op July 8th.

I had my surgery on August 4th for gland removal and lipo. I had 300ccs of fat sucked from each side and the glands removed. I had poofy nipples as well as gynecomastia. I'm now nearing my 8th week post op and my nipples are still slightly poofy. The poofiness is pretty minimal, but it still slightly distorts my chest. I still have that small semicircle of scar tissue where the incisions were made, and I hear that those are what makes the nipples remain poofy? My surgeon seems to have left a little more fat in the left side, and I also notice that the left nipple is slightly poofier, but the scar tissue also feels thicker than on the right side. I'm hoping that my nipples will flatten out because right now my chest looks like a minor case of gyne, rather than a corrected case of gyne.

How long did it take for most of your nipples to flatten out (if you had poofy nips) after surgery? I think I'm also gonna start working out more consistently soon, as I was exercising consistently pre-op and basically stopped altogether post-op, because I'm concerned I may have gained between 2 or 3 pounds post-op. Two or three pounds shouldn't change very much for me, because I'm not below average height or weight (6', 175lb post op) but it's making me paranoid.

I'm sure many of you have been in my exact situation, so any help would be appreciated.

- James















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