1 week post-op issues

[nick71]

Hi everybody,

I just had my gyno surgery performed one week ago by a board certified plastic surgeon who performs hundreds of these procedures every year.

He saw me 2 days after the surgery (gland excision + lipo) to remove the ace bandage and he told me that everything was perfect.

I'm currently facing two issues and unfortunately my doctor is traveling out of the country and he won’t be back until the end of October.

I would be really grateful if someone could assist me with the following:

1) When I pass my hand over the sternum area, I can feel that there is liquid underneath, and I also can hear a squishy sound when passing my hand on the sternum area. I guess the body will reabsorb the liquid, I just wanted to double check to see whether it's a normal occurrence.

2) The most concerning thing though it's the crater under the left nipple. The left nipple looks completely different from the right one, and in addition there is a crater which is even more noticeable when I'm sitting or leaning forward. I’m aware that it's just 1 week post op, however since I don't have this issue on the right side, I'm pretty concerned. Also, when I raise my arm the crater becomes bigger and expands from the nipple to the sternum area.

Can you already tell 1 week post op if this crater is the results of too much tissue being removed? I know that I need to be patient, let the body heal and that the final results won’t be seen for several months. However, since there seem to be tissue missing (at least to me, but I'm no expert), I wonder how it could come back, even in several months.

Is there anything that can be done to reduce the crater while the chest heals? I read that sometimes massages work, however how soon can I start massaging? Also, the worst thing that could happen if I massage is that it would have no effect (i.e. wouldn't help getting rid of the crater), or could massaging make the crater worse?

In addition, would tighter compression on the chest help with the crater, or would it make no difference? The compression shirt that I have is not very tight, so I just bought an Ab Belt to compress the chest a bit more, however if this wouldn't help or would make the crater worse, kindly let me know.

I apologize for all the questions :-).

I have attached some picture to give a better idea of the crater issue.

Thanks a lot for your help! Nick

[nick71]

sorry guys, I'm reposting the last pic since it is upside down in my previous post...

[nick71]

here are 2 other pictures with my left arm raised. Thanks for your assistance!

[Dr. Schuster]

The fluid feeling would make me concerned about residual seroma. This is usually treated with aspiration. The depression of the nipple looks like a little early retraction. This will usually resolve but massage might help. You really need to contact your surgeon's office to find out how your surgeon can be contacted. Most surgeon's today respond to email. Neither of the problems are an emergency so you have time on your side.

[nick71]

Thanks a lot Dr. Schuster! I thought that seroma could appear mainly under/around the areola region, not under the sternum. In case it is indeed seroma, how long do you usually wait before aspirating it? I will try to contact the doctor's office again in order to get his feedback. 
With regards to massage, do you happen to have a link for a video that shows how to properly do it? I wouldn't want to do something wrong. I believe that I need to wait for the excision site to have properly healed prior to start massaging (which should be about 3 weeks post surgery), however what about frequency and duration? How many minutes per day? Thanks a lot for your kind assistance and have a great day! 

[Dr. Schuster]

I think that a seroma should be aspirated as soon as it is diagnosed. So you really need to get examined asap. Not all surgeons believe in massage so you really need to get further instructions by your own surgeon. Sorry.

[nick71]

Thanks Doctor, 
The liquid that was present in the sternum area is no longer there... at least I have some good news :-)
My doctor will return next week so I hope to be able to see him as soon as he's back with regards to the other issue.
Thanks again! 

[Litlriki]

Just reading this a little late, and hopefully your issues are resolving.  I'm just writing to comment on the squishy fluid over the sternum.  This is very common as a result of the liposuction, which creates tunnels under the skin.  Some fluid and air can remain in these for a couple days post-op, and the result is the bubble wrap feeling over the sternal region, which usually resolves in a couple days.  
Rick Silverman

[nick71]

Thanks Dr. Silverman! Indeed the bubble wrap feeling over the sternal region is gone... unfortunately the other issues are still present... I'm aware I need to be patient, however it can clearly be seen that tissue is missing in some areas, and as far as I know, it doesn't grow back... I'm going to wait to be 6 months post op and then I'll see what to do. 
Thanks again and have a great day! Nick