REALLY WORRIED!! 9 MONTHS POST-OP

[MrFlex]

Okay I posted on here about two months ago. My initial surgery was in May 2013. The surgery went well, I had the procedure where the incisions made on the sides of my chest rather than on the areola. My right side has healed up nicely (the flat, smaller nipple in the pics). The right (the larger, puffy one) has been taking some time.

In November 2013 I was schedule for a local anesthesia procedure for the right. An incision was made on the areola to remove what I believe was and excess amount of scar tissue. So for the right side I'm only 3 months out since the clock starts over.

But as you can see in the pics I don't see any progress. Its still just as puffy, and there is a large amount of scar tissue still under and around the areola. Its harder in some areas and it makes it hard to massage. I feel as if I'm too aggressive in my massages as the skin on my areola has started to show wear. I iced it and it still feels swolen and I'm not sure if that's from my massages or not.

I would think from the initial surgery as well as the one in Nov I would be further along. My doctor keeps assuring me its going to heal up nicely but I'm starting to think he did a botched job. Many of our post-op meetings are never more than a few minutes of him saying that and to give it time.

Please docs I need your opinions. I took the best pics I could from different angles. Any feedback would be appreciated. Thanks.

[MrFlex]

More photos

[MrFlex]

And more

[Dr. Elliot Jacobs]

The most common problem after surgery is the unpredictable (and unpreventable) development of scar tissue, which is usually just under the nipples.  We do not know why this occurs just under the nipples.

If your nipples were originally flat after surgery and then developed excess tissue, then it is likely due to growth of scar tissue.  If your nipples were never flat after surgery, then most likely there is additional tissue under the nipple that should be addressed.

If scar tissue is present, further surgery to remove it can temporarily make it better -- until the scar tissue forms again.  In my experience, the best treatment for scar tissue is injection(s) of cortisone, which will reduce the production of scar tissue and "dissolve" some of the existing scar tissue.

Would suggest a second opinion from an experienced gyne surgeon to help you out.

Dr Jacobs

[Litlriki]

I would agree with Dr. Jacobs, that the tissue may be scar, rather than gynecomastia, particularly as you've had additional excision.  Fullness and even prominence of the nipple can result from the scar tissue that Dr. Jacobs described, and that can be effectively treated with Kenalog or other corticosteroid injections.  As noted, however, if there's still too much gland there, additional excision will be required.  But you should give yourself at least 9 months (or longer, since you already had a revision) before you consider further revision.  Kenalog injections can be tried sooner.

Rick Silverman

[MrFlex]

Thank you Dr. Jacobs and Dr. Silverman for your responses. I have good reason to believe it is just pesky scar tissue. My next post-op is in a few weeks. I'll contact my doctor about possible injections or further procedural corrections if necessary.