7 Months on revision for slight puffiness or will it go?

[sunnyUK]

Its been 7 months now since I had both glands and lipo done and I'm 75% happy but but my nipples are still a bit puffy when they are not hard, I can more lipo done for free (I have to pay the travel and accommodation costs) but is it worth getting it done or should I wait a bit more? I'm really stuck, my chest looks amazing when the nipples are erect.

[George Pope, M.D.]

I think you look fine.  You provide no preop photos, but you certainly have a flat chest now.  Have you followed up with your surgeon?  What does he/she say?  Be sure to make all of your follow up visits with your surgeon. 

Dr. Pope, MD

[DrPensler]

It a bit difficult for me to fully analyze the photos. In the first you appear at rest without your muscle flexed.In the second the pectoralis major appears to be flexed and your arms appears to be pushing the skin medially.I like to assess things at rest which would be the top photo,which looks good. Without knowing what exactly you are doing in the photo my best guess would be to give the area a bit more time.

[Dr. Elliot Jacobs]

We have no pre-op photos for comparison.  But on your second photo, with the chest flexed, there does seem to be a bit of puffiness of the nipples.  This MAY be scar tissue, for which an injection of cortisone may be all that is needed.  On the other hand, if this situation has remained unchanged from day one after surgery, then it may be residual sub-areolar breast tissue.  Revision surgery would be required in this case.

Dr Jacobs

[sunnyUK]

We have no pre-op photos for comparison.  But on your second photo, with the chest flexed, there does seem to be a bit of puffiness of the nipples.  This MAY be scar tissue, for which an injection of cortisone may be all that is needed.  On the other hand, if this situation has remained unchanged from day one after surgery, then it may be residual sub-areolar breast tissue.  Revision surgery would be required in this case.

Dr Jacobs

I only have 1 pre-op picture which is not very good quality sorry.

The clinic keep saying to wait a bit longer.

Should I go and see my local GP about the cortisone option? As I live in the UK but had my surgery in Poland.

[Dr. Elliot Jacobs]

As I previously stated, if your puffy nipples were never flat after surgery, then there is most likely residual tissue there and you should return to your surgeon for evaluation and possible revision surgery.

If your nipples were indeed flat after surgery, then the new puffiness may be scar tissue, in which case some cortisone injections might be useful.

Only you will be able to tell because scar tissue and residual breast tissue actually feel quite similar.  The diagnosis and subsequent recommendations for treatment is based on your history -- not so much with a physical examination.

If indeed cortisone injections seem to be the way to go, then would suggest a plastic surgeon rather than your GP, who would probably have minimal experience in injecting cortisone into scar tissue.

Dr Jacobs

[sunnyUK]

As I previously stated, if your puffy nipples were never flat after surgery, then there is most likely residual tissue there and you should return to your surgeon for evaluation and possible revision surgery.

If your nipples were indeed flat after surgery, then the new puffiness may be scar tissue, in which case some cortisone injections might be useful.

Only you will be able to tell because scar tissue and residual breast tissue actually feel quite similar.  The diagnosis and subsequent recommendations for treatment is based on your history -- not so much with a physical examination.

If indeed cortisone injections seem to be the way to go, then would suggest a plastic surgeon rather than your GP, who would probably have minimal experience in injecting cortisone into scar tissue.

Dr Jacobs

Ok my surgeon has agreed to do a revision, basically doing a touch up removing more tissue, I'm just worried that re-opening the nipples on the old scars would create an even bigger scar? Can tissue still heal fine if its re-opened?