Post OP gynecomastia surgery 8 days, still puffy nips

[missionmusclenips]

Hi, Im Male 33, I had puffy nips , and gynecomastia, resulting from adolescent weight gain .  i was on anti depressants and SSRI type medication at 16, and gained 100 pounds in very little time, and then lost it when I came off the medication a year latter.  I wasnt left with any loose skin, just puffy nipples, and lumps (hard lumps) , under the areola. 
 
I am a body builder, and the leaner ive gotten and more cut the more it bothered me.  I have very low BF% , maybe 8 right now.

Im in Montana so plastic surgeon wise my choices were limited. I went to a plastic surgeon who seemed to mainly do alot of breast augmentations, 3 hours one way from me.

He did local anesthesia with oral sedation, and just did excision. 10 grams were taking from left, and 8 right.  I was put into a ace compression and sent home.  2 days latter i took it off, along with the gauze and showered.  My left nipple looks extremely puffy, maybe slightly more than pre op.  The right looks slightly less puffy then pre op, but still puffy neverthe less.  They both contract with water, or stimulation still, back to a very small areola, but its temporary .

I will inclued pics from before and now after. Please tell me what you think . I dreading that i need a revision, or a areola reduction. just doesnt make sense how such a minor case wouldnt shrink right away. some docs say the areola should retract in size 10-50 percent right away, and im worried. Ive been mainly wearing a compression UA shirt with the ace over the top of that. the ace constantly slips down and is a pain in the ass.

 

[missionmusclenips]

just uploaded a whole folder to photobucket it wont let me place the link in here. what the heck ?

[missionmusclenips]

post op 8 days

[missionmusclenips]

post op left side again the puffier one

[missionmusclenips]

heres the right side a little better, post op 8 days

[missionmusclenips]

Heres one of the before pics.. of the left side puffiness. pre op

[missionmusclenips]

Heres pre op again, but with the nipple erect, after being stimulated

[missionmusclenips]

one of the glands that was removed

[missionmusclenips]

pre op

[missionmusclenips]

another pre op

[Dr. Elliot Jacobs]

The treatment of puffy nipples appears to be simple and some surgeons may take a cavalier approach -- just cut out some of the gland and it will be fine.

The problem is that excision alone is usually not enough.  Once you remove the underlying tissue, the areola has no where to go so it puffs up again.  In my experience, significant undermining of the surrounding skin is needed to allow for appropriate skin re-distribution and re-draping.  This can be done with a liposuction cannula -- without suction applied -- as the only instrument.

You may be fine after the swelling goes down but if not, then you may have to return to your surgeon to discuss what else can be done.

Good luck!

Dr Jacobs

[missionmusclenips]

Ok so from what I've read lipo to re contour the area and some " fat flaps " possibly should have been done ...

Well being I'm day 8 .. Gauging from
The pictures is it possible
For everything to reduce down or is it for sure a revision I'm lookin at

[Dr. Elliot Jacobs]

It's really really early in the healing stage and there is no way to predict final results at this point.  Just be patient and allow everything to heal -- it will take a minimum of several months.  There is no guarantee that revision will be needed.

Dr Jacobs

[missionmusclenips]

Man i hope it just goes down. Im happy with the right side already. darn

[missionmusclenips]

Doctor Jacob Elliot,

thanks for the replies , i appreciate your candor.  Im obviously obsessing about this .. shoot gynecomastia is one of those things that can drive you crazy.  Im literately praying for a miracle that these puppies lay flat, here in a cple weeks, ill be devestated if i need a revision. 4-6 weeks out the gym now is enough to get me bat shit crazy.

So in all cases do you have to use some amount of lipo / fat flaps tricks to get the areola to lay flat?   Obbiously my surgeon just took the glands out, i can feel around behind the nipple, theres nothing behind it anymore, no hard masses like before.  UGGGGGGGG .