Help-what is you opinion on these issues?

[Florida Guy]

Hello,
I'm going on 8 weeks now post gyno surgery.  The only major problem I have had with the surgery was fluid build up on one side of my chest.  Amazingly, that problem was drastically reduced with the use of compression shirts starting on week 4.  My surgeon did not say anything about them so I tried them out to reduce the fluid build up and it worked great! (I am still weariing one 24/7 for good measure for a couple of more weeks).

Now, my concerns,
My surgeon has recently commented that I may have to have some type of follow up surgery involving plastic surgery.  This was after I mention my concerns (listed below) during the last visit.

Issues:
1. On my lower left chest area there is a small amount of what I assume to be tissue below my nipple-this is not fluid build up. My surgeon stated that a few months will tell a better story on how to proceed with this issue.  The problem is that this small amount of "tissue" looks odd compared to the opposite side of my chest and it looks as if I have half of a left nipple (nipple partially obscured by the tissue).  the right side is not like this at all.

My question is what will need to be done to remove this small amount of tissue?
Will it be similar to repeating the gyno surgery procedure with incisions, drains, etc?

2.  I have very noticeable "craters" and indentions in my lower chest that create an odd-looking contour to my lower chest (especially when flexed) due to the large volume of material that was removed. 

Will these areas smooth out to a better contour or is it commonplace to have some type of plastic surgery after healing up from the initial gyno surgery for the appearance?

Thanks in advance for any advice.

[Dr. Elliot Jacobs]

Your questions and concerns are best addressed to your surgeon, who knows exactly what was done.

At eight weeks, you are in the "no mans land" of healing -- much too soon to know if any further surgery or treatment would be necessary. 

Your surgeon will probably tell you to wait for several more months, then re-evaluate for any other treatment.

Dr Jacobs

[DrBermant]

Hello,
I'm going on 8 weeks now post gyno surgery.  The only major problem I have had with the surgery was fluid build up on one side of my chest.  Amazingly, that problem was drastically reduced with the use of compression shirts starting on week 4.  My surgeon did not say anything about them so I tried them out to reduce the fluid build up and it worked great! (I am still weariing one 24/7 for good measure for a couple of more weeks).

Now, my concerns,
My surgeon has recently commented that I may have to have some type of follow up surgery involving plastic surgery.  This was after I mention my concerns (listed below) during the last visit.

Issues:
1. On my lower left chest area there is a small amount of what I assume to be tissue below my nipple-this is not fluid build up. My surgeon stated that a few months will tell a better story on how to proceed with this issue.  The problem is that this small amount of "tissue" looks odd compared to the opposite side of my chest and it looks as if I have half of a left nipple (nipple partially obscured by the tissue).  the right side is not like this at all.

My question is what will need to be done to remove this small amount of tissue?
Will it be similar to repeating the gyno surgery procedure with incisions, drains, etc?

2.  I have very noticeable "craters" and indentions in my lower chest that create an odd-looking contour to my lower chest (especially when flexed) due to the large volume of material that was removed. 

Will these areas smooth out to a better contour or is it commonplace to have some type of plastic surgery after healing up from the initial gyno surgery for the appearance?

Thanks in advance for any advice.

8 weeks can be very early after surgery with some techniques.

Posting Standard After Gynecomastia Pictures can help other better understand your concerns.

How Soon Do You See Results After Gynecomastia Surgery depends on many factors, we tend to see instant results for my patients.  However, I prefer to optimize Healing After My Male Chest Surgery such that early results are possible.

Firm tissues after surgery can be residual gland, but also can just be healing tissues or scars.  Different surgical techniques injure tissues to different degrees. Time to tissues softening can vary depending on the original problem, what was done, after surgery care,
Scar Care, After Surgery Compression Garments, and many other factors. Options depend on the problem to be treated. Time can range from 6 months to a year but can vary depending on many issues best explored with your doctor.

I see many patients who complain of residual Puffy Nipple Gynecomastia after another doctor's surgery.  There are many possible problems causing such a deformity.  The most common is remaining gland behind the areola as seen in these Anatomy of Puffy Nipple Drawings.  Check out the images with the link for remaining gland after surgery to see what I mean. 

Liposuction is great for fat, but does not do well for gland at all.  As shown in the anatomy link, there are usually fingers of gland between fingers of fat.  Liposuction no matter what technique (sharp cutting cannula, specially designed cannula, ultrasonic, laser, or "smart") targets the fat first.  Remove the fat and the gland remains behind condensing the fingers making a firm mass.
 
Even if the doctor achieves a flatter chest, that firm mass does not look like fat, move like fat, or compress like fat.  It just does not move well or look good (especially on animation).  That is why few doctors will show results with chest muscles tightened or arms up over the head or movies showing the tissues in motion.

Crater Deformity After Gynecomastia Surgery, when seen at rest, usually will not go away on its own.  Healing tissues can adhere initially after surgery causing a slight depression on animation that resolves with scar care and time.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia Surgery