am i in trouble?

[Ride09]

Sorry to keep bombarding you guys with these questions but i'm still in my "freak out" stage of recovery where every thing worries me. Today is my 5 week post op day, and I have two concerns. BTW, I had excision only. He took out some fat as well but only in my nipple area where I had decent sized "puffy nipple gynecomastia".

My right nipple is very puffy and has a crease on the bottom as well as on top, but the sides are completely flat with the skin. Is this blood? fluid? scar tissue? Called my PS and he said swelling is normal and not to come in to check it but I am still worried.

My left side is what is driving me crazy right now. The nipple crease I had since day 1 post op has not gone away. The bottom of the nipple is swollen along the incision so I believe it to just be scar tissue. However the top and middle are sunken in and giving it the folded look. When I flex it becomes indented. Is this most likely scar tissue just attached to the nipple that will release it with time?

I appreciate any input you can give.

[Ride09]

The last picture is my left nipple flexing. As you can see when using the muscle it folds in more. I can not for the life of me figure out what is causing this. When I raise my arms over my head I can feel what ever it is attached to pulling down.

[Litlriki]

The photos are pretty demonstrative, but it's tough to know how this will resolve over time.  I suspect that most of my colleagues here would give you the same recommendation--basically, give the healing process some times. and massage the area to manage the scar tissue.  It's still early in your post-operative course, so the area will change over time. Massage can help to make the area more supple and break up scar, though you may still require some intervention.

Rick Silverman

[Ride09]

Appreciate it Dr. Silverman. However, my PS told me not to start massaging until after my next visit, at which point i will be almost 2 months post op. Is there a chance waiting too long to start massaging will cause these changes to set in permanently? Or can the scar tissue always be broken up at any time by massaging?

[Ride09]

Went to my PS yesterday, he told me the swelling was unusual but to start wearing my vest again and see if the body would reabsorb the fluid causing puffiness. If not it will need to be drained. The fold on the left side he said was caused by the suture inside my chest having not fully dissolved yet. Guess i'll just have to wait it out a few more weeks and hope for the best.

[Litlriki]

I encourage my patients to massage the area fairly early, but you should follow your surgeon's instructions.  I would think that by now it should be safe to massage, though you didn't comment if that was part of his recommendations.

RS

[Ride09]

Sorry forgot to mention that. He told me I can massage the side with the fold (left side) but not to massage the right side yet. If he has to drain what ever fluid is in there is it a simple process? I'm guessing just sticking in a needle and that's it right?

Appreciate the advice.

[Litlriki]

Yes, drainage can be done with a needle, and it's fairly simple.

RS