17 month post-op: Uneven, skin bunching and indentations

[cb2000]

I am grateful to the excellent doctors on this site and the advice and help they offer to us. So a big thank you to them!

I am in my mid 40s, had a mild case of gyno/fat in chest/nipples area.
6ft, 175lbs, same weight for last 20 years, never been fat and no skin elasticity issues.
Surgery 17 months ago with a reputed surgeon. Bilateral lipo and breast tissue removal via incision.
Surgery went fine. I had more problems with the right side (swelling, brusing, black nipple) and there is still some discoloration on that side as you can see in the pictures.

When I stand with my arms down and erect posture, my chest looks ok. But with any flexion or arms in forward position, I see weird bunching of skin, indentations, possibly some loose skin, etc.

Is this a normal outcome? I have been very patient through the whole process and hoping it will get better but with 17 months gone, this may be close to the final outcome.

Is this uneven fat? Can it be fixed? Any advice will be much appreciated.

Thank you!

[Litlriki]

The degree of skin tethering doesn't appear terribly extreme in the photo you posted.  I encourage my patients to massage their chests to minimize tethering from scarring.  Still, one may see some mild contour changes with dynamic activity.  But actually, except in the leanest of individuals, chest flexion can  cause changes on the surface of the skin.  Whether or not your complaints could be remedied by a secondary procedure is not clear based on the photos.  It's probably too late for massage to have any effect.

Rick Silverman

[cb2000]

Dr. Silverman,

Thank you for the feedback and advice.

Some of it is scar tissue/tethering. There were firm knots that have become softer and smaller with time. Interestingly the two worst locations of scar tissue were below both aerolas along path of the drains (stayed in for 4 days). They looked like rolls of nickel after the drains came out. I did a lot of massaging in the first six months and less since then. I will continue massaging in case it helps.

Other areas, e.g., my left side below armpits appears to be fat that was not lipo'd enough. This area has been soft from the start and very different feel/texture than the scar tissue.

In your expert opinion with these limited pictures, do you think steroid injections could still help at this late stage?

Thank you!

[DrPensler]

At 17 months massage may help but I would agree its unlikely to have a large effect.Steroids would be worth a try I commonly use it in patients with minor adhesions .Typically a couple of injections separated by two to three months would be required.

[cb2000]

Thank you Dr. Pensler. I think steroid shot is my best option for now. If it does not improve, I will re-evaluate.