Afraid of incompetency in my doctor.

[4thseal]

I always thought I had larger than "regular" glands. I got a doctor that didn't seemed to think that my glands were of irregular size. Anyways, as I had to save up for the procedure, I returned about 2 years later. This time I was assigned to another doctor (the one who operated on me about 7 weeks ago). He also didn't seem to think my glands were irregular, and thought that I only had fat. Therefore, he recommended me to remove the gyno by lipo only. (after all, I thought if 2 doctors thought it was only fat, they were probably right)

Now about 3 weeks after the surgery, I noticed swelling right under both nipples. They both felt hard and painful. I read that post-op swelling may occur and even last for a while, so I decided to wait it off. However, I started noticing that the swelling was not going down, and whatever accumulated under there was still very hard and it still feels sore when touched. Furthermore, it portrudes a lot with everything I wear.I read online, and probably on this site as well, that it could be scar tissue, and if it was, that there were shots to melt the tissue away. I saw my doctor again this week, and he told me that what I now have is a combination of scar tissue with a gland and this could only be fixed by operating, but this time also removing some gland instead of just lipo.

Now, reading about the "kenelog" shots made me start wondering if my doctor's incompetent. Is the swelling I currently have just scar tissue? Could it be that only just now that the fat is gone he could identify that my glands were irregular? How do I know if it's scar tissue and not just my glands appearing now that fat is gone?  Can it be identified if I post pictures?

I would really appreciate your help and opinion before I make a big mistake.

[Dr. Elliot Jacobs]

If you are only 3 weeks post op, it is much to early to decide anything.  Best advice is to follow your doctor's advice and wait it out.  I would recommend at least 4-6 months of observation before you decide on kenalog treatment or any additional surgery -- it may all settle down way before then.

Be patient!

Dr Jacobs

[DrBermant]

I always thought I had larger than "regular" glands. I got a doctor that didn't seemed to think that my glands were of irregular size. Anyways, as I had to save up for the procedure, I returned about 2 years later. This time I was assigned to another doctor (the one who operated on me about 7 weeks ago). He also didn't seem to think my glands were irregular, and thought that I only had fat. Therefore, he recommended me to remove the gyno by lipo only. (after all, I thought if 2 doctors thought it was only fat, they were probably right)

Now about 3 weeks after the surgery, I noticed swelling right under both nipples. They both felt hard and painful. I read that post-op swelling may occur and even last for a while, so I decided to wait it off. However, I started noticing that the swelling was not going down, and whatever accumulated under there was still very hard and it still feels sore when touched. Furthermore, it portrudes a lot with everything I wear.I read online, and probably on this site as well, that it could be scar tissue, and if it was, that there were shots to melt the tissue away. I saw my doctor again this week, and he told me that what I now have is a combination of scar tissue with a gland and this could only be fixed by operating, but this time also removing some gland instead of just lipo.

Now, reading about the "kenelog" shots made me start wondering if my doctor's incompetent. Is the swelling I currently have just scar tissue? Could it be that only just now that the fat is gone he could identify that my glands were irregular? How do I know if it's scar tissue and not just my glands appearing now that fat is gone?  Can it be identified if I post pictures?

I would really appreciate your help and opinion before I make a big mistake.

3 or 7 weeks after surgery is too soon with some techniques to tell what is going on.

Standard After Gynecomastia Surgery Pictures or Standard Video After Gynecomastia Surgery can show residual deformity, swelling, bruising, dynamic issues, and help other understand your concerns.  Neither the pictures nor movie will demonstrate if the deformity is swelling, residual gland, or scar tissue.  All three can be firm and distort contour.

Liposuction Alone Can Leave Remaining Scar and Gland Gynecomastia Deformity.  Here is just one example of Remaining Gland and Scar After Liposuction Alone

Typically tissues need to heal and evolve before considering revision surgery. It can take 6 months or longer for tissues to evolve enough.  Revision decisions at 3 weeks is almost always way too early.  My patients rarely need Kenalog injections.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery