Frustration with Ace wrap conflict

[pistolpt]

I'll try and make this fast, as I truly appreciate any insight on my situation. My surgery (May 14th) involved removal of glandular tissue and fat with excision of excessive skin on the left and movement of the entire nipple. I am going on post-op day 12 and my surgeon had me wear an Ace wrap for the first 4-5 days after surgery until my first post-op visit. Then he said to wear it intermittently if I felt I needed it, but to continue and apply a small amount of neosporin to some sterile gauze and tape over the L nipple. I have steri-strips mostly intact and no s/s of any infection, no pain, and the nipple looks great at this point. My only concern is the amount of swelling that changes daily depending on my activity level and the lack of a pressure garment concerns me and frustrates me even more. I don't want to look back on this and wonder "what if I would've used one?" With everything I have read and heard, I have yet to see anyone or hear of anyone, on this website or elsewhere that has gone without a compression garment. When I asked him about it, he said they he does not find them as important as people believe and that research shows an Ace wrap is just as effective. He said I could use a compression garment if I wanted but then after further discussion, he said let's hold off until the next follow up at 20 days post-op. I understand everyone's surgery is different with many variables but as I mentioned, with all the differences with surgical procedure and post-op care everyone seems to use the compression garment. Any insight would be appreciated. Thanks.

Pete

[Litlriki]

Pete,

Sorry to hear about your frustration.  I'm not sure why your surgeon would discourage you from getting some sort of compression garment, and perhaps you should ask him very specifically why he doesn't want you to wear one.  As surgeons, we are accustomed to our patients coming in with much better--or at least much more--information, since they can search out topics of interest on the internet.  Feel free to cite the information you've gleaned from this website, and explain that it seems that compression is used fairly universally by all of the surgeons who post here and who answer questions, surgeons who focus their practices on treatment of gynecomastia.  He may have a very specific reason for wanting you to NOT use a compression garment, but I can't think of one, other than concern over vascular compromise to the tissue.  In that case, even compression of the sort that one gets from a compression vest should not cause any undue consequences in my opinion, but he knows more about you and your procedure.

Good luck,

Rick Silverman

[pistolpt]

Thank you Dr. Silverman. I sure will. Again, thank you for the time you provide everyone.

[Dr. Elliot Jacobs]

To be blunt, I am mystified at your doctor's seemingly casual approach to your wearing a compression garment.

After gyne surgery, there is healing that goes on for many months, but the first few weeks are perhaps the most critical.  You can see for yourself that swelling comes and goes depending on your activity level.

I make two very strong points to my patients:  minimal physical activity for 3-4 weeks and constant application of snug compression.  This will aid your healing in a significant way.

BTW, did your doctor provide the Ace bandage for you?

Dr Jacobs

[DrBermant]

I'll try and make this fast, as I truly appreciate any insight on my situation. My surgery (May 14th) involved removal of glandular tissue and fat with excision of excessive skin on the left and movement of the entire nipple. I am going on post-op day 12 and my surgeon had me wear an Ace wrap for the first 4-5 days after surgery until my first post-op visit. Then he said to wear it intermittently if I felt I needed it, but to continue and apply a small amount of neosporin to some sterile gauze and tape over the L nipple. I have steri-strips mostly intact and no s/s of any infection, no pain, and the nipple looks great at this point. My only concern is the amount of swelling that changes daily depending on my activity level and the lack of a pressure garment concerns me and frustrates me even more. I don't want to look back on this and wonder "what if I would've used one?" With everything I have read and heard, I have yet to see anyone or hear of anyone, on this website or elsewhere that has gone without a compression garment. When I asked him about it, he said they he does not find them as important as people believe and that research shows an Ace wrap is just as effective. He said I could use a compression garment if I wanted but then after further discussion, he said let's hold off until the next follow up at 20 days post-op. I understand everyone's surgery is different with many variables but as I mentioned, with all the differences with surgical procedure and post-op care everyone seems to use the compression garment. Any insight would be appreciated. Thanks.

Pete

Neosporin ointment does not mix with steristrips. The ointment often loosens the wound reinforcement.

Posting Standard After Gynecomastia Surgery Photos can help others better understand your concerns and document the current swelling / bruising / status of your dressings & compression methods.

Each doctor has his / her own techniques. They tend to stick with what they are used to. Why a dressing technique is used may have many possible reasons. I prefer to maximize my patients' comfort after surgery.

My Dressing After Gynecomastia Surgery protects the wound, is sealed so there is no bloody mess, extremely thin, permits the underlying contour to show, and permits the overlying materials to be changed easily. I use gauze padding to fill in the valleys not compressed by our After Surgery Compression Garments. This is a single garment without additional undergarments, no over wraps or additional compression.

An ace wrap tends to slide, have a non-reproducible pressure / compression, and much more difficult for a person who is alone to apply. I particularly do not like the amount of extra pressure they can apply, so much that blood supply can be affected hurting tissues. Rarely will I add an Ace Wrap over the compression garment. This tends to be for patients with a rare hematoma when I want extra pressure to help get the blood collection out.

Beyond comfort and care, my dressing and garment are designed for stealth, having the least obvious method so those patients who prefer, they can better conceal that they have had surgery from the public. My patients tell me they do not need loose fitting thick clothing to hide their garments while out in public.

It is all a matter of what takes to maximize the patient experience. Careful documentation of early after surgery tissue evolution and patient use of pain medication led me to what I use. For me Comfort After Gynecomastia Surgery is critical. Photographs on my website are designed to lessen my patients anxiety about such issues. Experiences posted on my website are typical for my patients and my techniques. To validate how another doctor's methods work, look for early after surgery pictures / movies, how much Bruising and Swelling, read what their patients say about the operation and recovery, how much pain medication do they take, and other such factors. Some doctors do not show that detail either on their web sites nor during their consultations. In that case it becomes a detective hunt trying to find pictures and experiences posted on forums.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Dr. Cruise]

I routinely have my patients wear snug compression for the first 3 weeks and then gentle compression for an additional 3 weeks.  The reason being is the overlying skin has been separated from the underlying muscle.  Without compression, it is more likely that fluid will build up in between and less likely that the skin will reattach to the muscle in a timely fashion.