Nasty results 3 months post-op (photo included)

[apotti]

Hello everyone, 

I'm a 23 year old guy from Finland, and I had my gyno surgery 3 months ago. I think I had quite a rare case of gyno because it was only on one side. The other side was perfectly fine and didn't need a surgery. The surgery was done by a plastic surgeon under the public healthcare, so it cost me only about 100€ ($110).

I was told that the surgery went fine, they found a large gland under the nipple. The surgeon said it was approximately half of his palm in size (I know that's a bit weird way to tell the size), he removed most of it, leaving just a little bit behind the nipple. After the surgery I had no pain, and the healing began well. My chest and nipple were both noticeably flatter and I was quite happy with the results. 

I can't recall when, but after some weeks I noticed that my nipple had become puffier and larger, I didn't really worry about it too much by the time, because I thought that it's just a part of the healing process. I applied anti-scar gel twice a day and just waited for it to get better.

Now it's 3 months post-op, and no improvement can be seen. By trying the chest I can feel that there's a huge amount of hard tissue under the cut, nearly all of it on the outer side of the nipple. Behind the nipple there seems to be not much of anything, so I'm guessing this is some heavy internal scarring? For the last 1.5 months I've been also massaging it regularly.

I'm seeing my plastic surgeon quite soon, so should I ask for cortisone-injections, or is it too early? I think what he's going to say is that "it will get better by time", but I don't think I'm really patient enough to wait. So I'm asking is there a lot of cases where the patient had bad results ~3 months post-op but then had miraculous healing after that? Is there really any hope that time will make it significantly better? I included a photo of how my chest looks today, I think all of you can understand why I'm not happy with the result so far, just by looking at it.

Okay, all is not negative: the side that was operated of the chest is now quite a bit flatter than it was before. So I can finally wear a t-shirt without everyone noticing that the right side of my chest is significantly bigger. And also, there's no pain on the chest anymore when pressure is applied. Before the surgery holding the guitar against my chest caused me a lot of pain (strangely) or lying on the floor on my stomach. That was the main reason why I wanted the surgery.

Sorry for my bad english

[apotti]

I forgot to add that maybe 1 week post-op I had a bit of hematoma below the nipple. I thought it was a normal part of the healing, which it isn't? It wasn't nearly as severe as in some pictures I can find from the internet, but it was noticeable. It healed itself quite quickly though.

[Dr. Elliot Jacobs]

Yours is a complicated story and it is difficult to render an opinion.

First, your post op photo appears to show a significant amount of residual tissue on your right side.  IF this is much better than pre-op., I shudder to think what your pre-op condition was like.  As a surgeon, I would never accept such residual assymmetry after gyne surgery.

Yes, there may be scar tissue under the nipple or residual breast tissue or both.  

Finally, the post-op hematoma may have contributed to some scar tissue formation.

Only your own surgeon will have some idea of what is going on.  Cortisone injections may or may not be indicated.

You might serve yourself well by consulting another plastic surgeon for a second opinion.

Good luck!

Dr Jacobs

[Litlriki]

It's difficult to say what exactly is going on, though it appears that there is still asymmetry with a moderate amount of tissue remaining on the right side.  It's possible that this may be fatty in nature, in which case a touch up liposuction procedure might help give better symmetry.  If, on the other hand, glandular tissue was under-resected, it might be necessary to excise more tissue.  Your surgeon may be able to tell you what he thinks the issue is based on the surgery he performed as well as palpating the area to feel for gland versus fat (this can be difficult, but sometimes the gland is firmer than surrounding fat,)

[apotti]

Thank you very much for your answers!