Creasing along side of chest post-op

[torontopatient]

Hi Docs,

First off, thank you for all of the time you guys spend on the forum relieving the concerns many of us have.

I have a quick question, I am about 2 weeks post-op now and have noticed creases along the sides of my chest (on both sides). These creases extend basically from the liposuction incisions under the armpit and stop close to the nipple. To the touch, there is a thin lump/raised area that extends the length of the crease, which I presume is scar tissue.

Just wondering from your experiences, is this normal, will it subside with time and what are your suggestions, if any? I know it's extremely early and I should be waiting months for the final results to become evident, but just wanted to hear your thoughts.

Thanks!

[Litlriki]

I'm not sure if what you're describing is related to the subcutaneous tunnels created by the liposuction, or if it's related to skin laxity after removal of the underlying tissue--or something else.  In either case, most issues of this nature are transient, and the appearance improves over time after the surgery, sometimes with the use of massage to the area.  You might post some photos if it's something that can be demonstrated with a photograph, in case it's related to something else.  The fact that it's on both sides makes it seem like whatever it is is "normal."

Rick Silverman

[DrPensler]

A photo would be helpful,it could be a compression garment issue or swelling.

[torontopatient]

Dr. Silverman, Dr. Pensler,

Thanks for your responses. I have attached photos below of my right side (the left side isn't nearly as bad). Just as a background, I am now 15 days post-op. Absolutely nothing was wrong with the appearance of my chest until roughly 9 days post-op. Then almost overnight, the crease appeared and now you can feel a ridge/tunnel underneath the skin right along the crease. It leads into a very firm area around the areola which I presume is scar tissue (which also was not overly apparent until the 8-10 day mark). This crease is also causing my right nipple to puff out considerably.

As a side note, I am concerned this can be partly attributed to lack of compression. I was given an elastic band/dressing to wrap around my chest which provides adequate compression but I find it slips down below my chest when I am sleeping. Thus I periodically wake up in the middle of the night and have to readjust it, so unfortunately there are likely long periods during the night where it is not properly compressed.

With all that said, have you seen this happen before and what do you predict my next 4-6 months will look like? I have been massaging several times a day and am wondering if there are other things I can be doing. I have my second follow up appointment with my PS next week.

Thanks in advance for your insight.

[DrPensler]

I see what you are referring too in your previous note. I suspect it may be due to the ace wrap. If this is due to the compression wrap it tends to improve.Whether it will completely resolve, time will tell. If liposuction was performed in the area with over resection of fat it might not resolve. In any case at this point time is your friend.

[Litlriki]

I would agree with Dr. Pensler, and hopefully if it was due to over compression at that one spot, it will even out without or with more even compression (such as a compression shirt).  I have my patients wear a vest or compression shirt for 4 weeks post-op. I find that other wraps just don't stay in place and are often less comfortable. 

RS

[Dr. Elliot Jacobs]

Agree with my colleagues.  The crease seems more likely due to poor placement of your Ace bandage.  Best to get a broad, smooth compression garment and it should even out over time.  Be patient.

Dr Jacobs

[Dr. Cruise]

I agree with what others have said... Photos would be very helpful to help provide accurate advice. Also, make sure your compression garment isn't too tight. This is a common issue. While you are early on in the healing process, it's good that you are aware of how your body is progressing, so you can address these issues early on.

Have you asked your surgeon about the issue yet?

[torontopatient]

Thank you to all who have provided your opinion. I have spoken with my surgeon and after a week of using a different garment the crease is slowly fading. Looks like it was nothing to worry about it.

In week 4 I am now seeing excessive scar tissue forming underneath and around both areolas, making for a puffy appearance that resembles my pre-op chest. I know this takes time, so hopefully this will gradually dissipate as well. Any thoughts? I've been told to keep massaging and wait. Wondering if the docs here can provide some reassurance based on your own experiences...

Thanks again.

[Dr. Cruise]

I am glad to hear your crease is resolving. I have experienced that and I instruct my patients to elevate the crease with two fingers. So that the crease literally is pulled off the chest wall. Essentially pinching the skin but right at the crease. You do not want this crease to fuse to the chest wall. Elevating it for 30 seconds every two hours will take care of it.
In regard to your tissue under the areola, it is likely scar tissue. Scar tissue is normal. It maximizes at about 6-8 weeks and then softens. Compression helps prevent scar tissue formation. Steroid injection is not unreasonable but this is a decision your doctor should make.
Good luck,