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Question about post-op healing

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Question about post-op healing
« on: April 21, 2010, 08:34:10 PM »
I had my surgery 3.5 months ago and I think what I am experiencing is swelling.  My nipples are almost exactly like they were before.  They looked much better earlier in my healing but now the swelling (or whatever is under my nipple) seems to be getting worse.  It is very squishy close to the surface but if I pinch it is rock solid just like my gyno was.  Can anyone tell me if this well go down?  I know that I had my surgery done from a very well respected surgeon in the plastic surgery community and he has performed this particular surgery for over 15 years so I trust him.  Is it possible that what I have will go down?  In my last visit (one month ago) he said I am experiencing swelling and that it won't be long before I can pinch my nipples and feel nothing at all.  But right now (3.5 months post-op) I had rock hard masses of whatever it is under each nipple and I am really discouraged.  HELP!

Thanks

Linkback: https://www.gynecomastia.org/smf/index.php?topic=20516.0

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DrBermant

Re: Question about post-op healing
« Reply #1 on: April 22, 2010, 07:14:32 AM »
I had my surgery 3.5 months ago and I think what I am experiencing is swelling.  My nipples are almost exactly like they were before.  They looked much better earlier in my healing but now the swelling (or whatever is under my nipple) seems to be getting worse.  It is very squishy close to the surface but if I pinch it is rock solid just like my gyno was.  Can anyone tell me if this well go down?  I know that I had my surgery done from a very well respected surgeon in the plastic surgery community and he has performed this particular surgery for over 15 years so I trust him.  Is it possible that what I have will go down?  In my last visit (one month ago) he said I am experiencing swelling and that it won't be long before I can pinch my nipples and feel nothing at all.  But right now (3.5 months post-op) I had rock hard masses of whatever it is under each nipple and I am really discouraged.  HELP!

Thanks

I had my surgery on Jan 6, 2010 and I am still quite swollen in one side.  When I have my garment on for a while it seems to get better but then as soon as I take it off it gets swollen and noticeable again.  How long will swelling typically last?  How long do I need to be wearing this garment?  Will not wearing it effect the healing process? (as in some way other than lengthening it?)

3 months can be very early after surgery with some techniques.

Posting Standard After Gynecomastia Pictures can help other better understand your concerns.

Early after surgery swelling can mask residual deformity.  How Tissues Evolve After Gynecomastia Surgery depend on many factors. Firm tissues after surgery can be residual gland, fat, but also can just be healing tissues or scars.  Different surgical techniques injure tissues to different degrees. 

I see many patients who complain of residual "Swelling" 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. 

Here are just a few of the many examples I have seen and treated:


The body typically needs to heal before considering revision surgery. Rushing into secondary surgery can be a mistake unless there are complications that need to be addressed or the next surgery is component of a staged procedure.  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.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia Chest Sculpture

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DrBermant

Re: Question about post-op healing
« Reply #2 on: March 02, 2011, 10:31:14 PM »
I was operated on January 10 of 2011 (almost 14 months ago) (had excision surgery) and my breast buds are the exact same as before.  After surgery they did seem to go down a bit but never did completely, so I believe I have a combination of scar tissue and breast tissue.  I know you are going to ask so I just want to say I would rather not post photos as I am a college student who lives with a bunch of other guys.  I am considering a revision but I almost don't even want to trust another surgeon as the last guy who cut into me claimed to being the best at what he does (though he mostly does woman's breasts) and I was even refereed to him by a family friend who is also a doctor.  I just don't know what to do.  I want to join the military but I just cannot do that having this issue, I feel disgusting, and hate this so much that it would actually dissuade me from following that dream.  I don't know how I could trust another doctor to cut into me and expect positive results when I already had the surgery and it was a failure.  On top of all of this whenever I see my surgeon and tell him I am unhappy with his job he just grabs the tip of my nipple and says there is very little left behind (however if you grab around the there is a whole entire chunk of mass.  I am not looking for perfection here, I just would like to be able to wear an undershirt or a beater and look normal like that.  I am so distraught about this because I feel like I have no where to turn, my parents paid for it the first time but only after sending me to multiple doctors and even a psychologist.  I will say that after my original surgery I was somewhat satisfied for about a month (especially thinking it was only going to get better and when it did not I became more depressed than ever).  Also I should add that even now 14 months later my breasts are still very sore but this may be because I am constantly playing with them just hoping one time I will reach up and they will be gone.  Sorry for the rambling and incoherence I am just desperate.   

Also my original surgery was $6000, is there anyway he should be obligated to return any of that money to me?  I mean anyone with a set of eyes can see that I still have gynecomastia.  And for the doctors on here I am wondering two things, typically how much does revision surgery run, is it the same price?  Also, not to call you gentlemen out or anything, I just have completely lost faith in my surgeon so I guess I'm taking it out on all doctors, I am just curious if the doctors on here are the best at what they do (as so many of these posts and patients claim they are) how is it that you have time to constantly be responding to us?

Sorry for the skepticism.

Someone help me, I'm desprate  :-\

Thanks to anyone who listens

My prior answer is still right on target other than now you are looking at the result of the prior surgery that probably will not change much. Since this post I added another resource you can find here on this forum about Puffy Nipple Complication After Gynecomastia Surgery. I see so many patients unhappy after operations done elsewhere that I build that resource do help others understand what I was finding.

https://www.gynecomastia.org/smf/index.php?topic=21332.msg144631;topicseen#msg144631

Cost of revision surgery depends on what needs to be done, but typically revision is much more complex than the original operation and can vary from doctor to doctor.

You can tell how good a doctor is by looking at their results. The results should be of multiple views showing how tissues flex and move. Here is a post I did on how to pick and evaluate a gynecomastia surgeon:

https://www.gynecomastia.org/smf/index.php?topic=16474.0

Hope this helps,

Michael Bermant, M.D.
Board Certified
American Board of Plastic Surgery
Member: American Society of Plastic Surgeons and American Society of Aesthetic Plastic Surgeons
Specializing in Gynecomastia and Surgical Sculpture of the Male Chest
(804) 748-7737

Re: Question about post-op healing
« Reply #3 on: March 02, 2011, 10:56:43 PM »
wow, my case (after the first surgery) looks almost exactly like the example you showed me in your link titled (Revision Gynecomastia After Partial Gland Excision).  Like that is kind of amazing.  Would you say these results are fairly typically for your second surgery patients or do they vary extremely from case to case?

Thanks Dr.

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DrBermant

Re: Question about post-op healing
« Reply #4 on: March 02, 2011, 11:31:06 PM »
wow, my case (after the first surgery) looks almost exactly like the example you showed me in your link titled (Revision Gynecomastia After Partial Gland Excision).  Like that is kind of amazing.  Would you say these results are fairly typically for your second surgery patients or do they vary extremely from case to case?

Thanks Dr.


Thank you for your kind words.

I work very hard to post typical results for my patients. It is my goal to have my patients tell me that their experiences were close to or better than what they see on my site. Each of my gynecomastia sculptures is a unique work of art and actually each side is different. But that is why I have put so many different examples up for the public to see what I offer for this challenging specialty of contouring of the male chest.

Hope this helps,

Michael Bermant, M.D.
Board Certified
American Board of Plastic Surgery
Member: American Society of Plastic Surgeons and American Society of Aesthetic Plastic Surgeons
Specializing in Gynecomastia and Surgical Sculpture of the Male Chest
(804) 748-7737


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