Post OP gynecomastia surgery 8 days, still puffy nips

[Dr. Elliot Jacobs]

Trying to feel for what tissue is present or not is deceptive and can be alarming to you.  Again, best bet is to allow for complete healing to occur and then re-evaluate with your surgeon.  It may heal just fine -- be positive!!

Dr Jacobs

[missionmusclenips]

Could it be that the swollen nips (puffy) are now due to a seroma behind them?  the tissue surround the nips seems watery, like jello when prodded at and if i flex and jump up n down it seems like a circle of around 1'' around both nipples.   I used a Plastic Surgeon , for this dont think he reserves special interenst in Gynecomastia, which was a dumb fucking move on my part.
  I just cant believe it , im a bodybuilder, with a fucking schedule to maintain, and i dread a revision. more $ and time out the window..

ne way i called there office, which is 3 hours one way from me, and told the assistant i thought i had a seroma, or fluid accumlation. she said this is totally typical , that i could come in, but he will most likely send me home to wait. Which seems totally contrary to what i have seen about seromas.

Im not day 15 post.
 can provie updated pics

[missionmusclenips]

heres some more having problems with pics

[missionmusclenips]

Day 15.. as you can see the left side is the worse, where it looks to be puffiest.. with a indentation around the nip. feels watery or jelloey..

[missionmusclenips]

darn im feeling like i should have flown somewhere to a Gyne specialist at this point.

[missionmusclenips]

Day 16 post . sunday night.

i can tell there is fluid *seroma* in my chest behind both nipples primarily left side. called the PS office, they told me to basically wait it out.

Today i decided to be proactive. I wiped myself down with a alchol pad, and used a 1'' 23 g needle to drain the left side. Was able to get around 10 cc from it. looks deflated and feels much better. Now im cooking dinner...working the nerve to do the right side.

[missionmusclenips]

Okay officially drained both sides around 5-6pm .  Im not at all recommending anyone do this, but truth be told my surgeon is 3 hours one way from me, and the front service staff lady pretty much blew me off on thursday. 

drained about 10cc from the left, and 4-6 cc on the right.   Instantly , my nipples seemed to shrink and the area tighten around the areolas. jelly feeling is gone, when i raise my arms for a double front bicep pose it looks much more aesteticly pleasing. Before it looked like water behind them circling around a 1'' area around the areola, that was puffed up and dome shaped.   The nipples seem to be staying smaller. I immedialtly put the UA shirt back on and ace wrap over .  Hopefully it doesnt build up again .  Either way now both sides look much better, especially that left side that looked worse than preop. I do notice some craters like flexing more apparent, like there was a bit much taken out, but it isnt terrible. hopefully that and small fold in the nipples will resolve within a few months. Im just happy to see them not as puffy for once ... I really was tripping out.

Id love multiple doctors opinions on this and i can post crystal clear pics in the morning again...

[Dr. Elliot Jacobs]

Clearly there was fluid present and the appropriate treatment was needle aspiration.  My only concern is that you treated yourself.  Putting a needle into a space containing fluid has the real possibility of introducing some bugs, which could result in an infection.  Doctors are trained in aseptic techniques to do this carefully.  I am not sure of your training to do this -- and it is a bad precedent for others on this forum to hear about.

You did a good thing to apply ace wraps afterwards.  This may help to keep the fluid from re-accumulating.

I would certainly recommend you keep in touch with your surgeon and tell him what was done.

Dr Jacobs

[DrPensler]

There are several interesting issues of note in your case. First I would note that bodybuilders are in no way an easy case. In many aspects although the amount of tissue present is not gigantic the expectations are. I do not mean that in the typical sense of a surgery patient with unrealistic expectations. Bodybuilders diet down and then under lights are evaluated in multiple positions with numerous muscle movements by experienced individuals looking for each and every flaw.After the competitions the contestants typically discuss with the judges what specific flaws were noted and ways to improve for the next competition. As has been noted a simple core out some tissue approach is rarely successful in any patient let alone this subset of patients.At this point as you undoubtedly know, but are hoping not to hear, is you need to let everything settle and soften before any evaluation can occur.After maturation of the scar/wound occurs a treatment plan can be formulated.Hang in there!

[missionmusclenips]

Well as far as being clean ( aniseptic spelling ?) technique , I just used a 23 g 1" fresh from the wrapper syringe and made sure to wash hand , take a shower first with antibacterial soap , then wipe area with alcohol prep pads. Let area dry then jabbed and aspirated as seen on YouTube . Because it's a 3 cc syringe it is a pain in the ass i would unscrew the barrel when it was full , empty it rescrew and drain again.
     Anyways I'm not endorsing anyone do this whatsoever . I'm unfortunately 6 hr round trip from thePS . There office has been in poor communication thus far .
     I've sent two emails , one a copy of some script on doctor Jacobs " puffy nipples " surgery that stated tissue must be undermined and fat flaps done - asking whether this was addressed and exerts I copied from
Websites illistrating this importance . Plus a seperate email about my concerns over the seroma which the front end staff were dismissive about over the phone .

Doctors:  thanks for your honest candid replies . I will take detailed pics tonight . Each journey documented may help influence another's decesion .

[missionmusclenips]

17 days post op you can see the difference since drained:

[missionmusclenips]

before being drained

[missionmusclenips]

Well i finally heard back from the surgeons office today. I told them that I had drained each side twice now.   She told me repeatedly, that it was unsafe, and unnecessary , saying that a normal patient will have up to 20cc of fluid build up after a gynecomastia procedure , and the body re absorbs it etc. Not sure I believe her, but I think I drained the bulk of the accumulation , and Im ready to sit back , relax and hope that a week n a half go by and show some improvement.  Still having suttle aches, and am not very comfortable in compression shirts or anything for that matter yet.  Anyways whats done is done, and hopefully I'll turn out positive.

  my one month post OP is on the 27th . 

[missionmusclenips]

day 20 post

relaxed, areolas .

[missionmusclenips]

day 20
relaxed aerola right side :