To an expert in kenalog injections!

[christianT]

Hello doctors,
I had a gynecomastia surgery for about 3 years ago, and everything went completely fine, except that I didn't got a post surgical compressor garment to wear. That resulted in development of hypertrophic scarring on both sides, which also is fairly asymmetrical. I am a 100 % sure it is scar tissue, as my chest was completely flat after surgery (couldn't barely feel a tiny bit of residual gland tissue). Anyway, I consulted a plastic surgeon regarding a kenalog injection, but he said that kenalog is only for extremely big scars (appendectomies etc.), and hadn't even heard of its use regarding gyno-scar tissue. So my only choice is to have my family doctor performing the kenalog injection. And don't worry, we will be on the very safe side, taking all precautions, and use a minimal dose and just take on step at a time slowly.
So my answer is; what would a recommended kenalog dose be for a fairly small lump of scar tissue? I know I cannot be given an exact answer, but just an estimate.

Kindly regards,
A 20 year old boy from Denmark

[Dr. Elliot Jacobs]

I politely disagree with your plastic surgeon.  I have used kenalog, in varying doses, on large or tiny scars, both on the surface of the skin as well as below the skin to deal with post gyne surgery development of scar tissue just underneath the areola.

You should consider seeking an opinion from another plastic surgeon.  Family docs are really not experienced in injecting cortisone.

Dr Jacobs

[George Pope, M.D.]

I have to agree with Dr. Jacobs.  Injection of a steroid medication such as Kenalog (Triamcinolone generic - not sure of Danish brand name) is commonly done with scars on the skin surface or scar tissue beneath the nipple-areola complex.  You should find a plastic surgeon who is willing to treat you this way.
Dr. Pope, MD

[christianT]

Hi Dr. Jacobs and Dr. Pope,

First of all I am very very grateful for your answers! Thank you very much.

But are you both sure, that my GP cannot perform the injection? He is indeed competent, and he has been working on a gastrointestinal surgery unit as well, because his dream was to be a surgeon. Also, he could immediately spot the scar tissue and the asymmetry of my chest. He was also familiar with corticosteroid injections for scar tissue treatment. 
  Otherwise my only option is to wait for 7 months, where I turn 21, and then pay for it myself in a private hospital. In Denmark we have free health care, so it would be with no fee if my GP could perform the injection(s).

[Dr. Elliot Jacobs]

Obviously this is your choice.  Kenalog (cortisone) injections have to be done correctly because it is a powerful medication.  Too much or the wrong place can potentially create problems.

If you have confidence in your GP, then ask him about his experience in treating similar conditions.  Then follow your instincts.

Dr Jacobs