Small lump after surgery

[DWilliam85]

Hello,

I had surgery to remove my man boobs not once, but twice. The second time the Dr. removed the glandular tissue by excision after I told him that's what I wanted to begin with. The technique used was the "Vaser, " lipo the first time.

I used the compression vest for 2 months straight and noticed a better result overall. I felt more confidant about myself.

Until, 4 months after that I started to notice slight pain in the areola area. I didn't think much of it as months went by and again I would get some pain for several hours and then it would go away. The pain became sharper from a 3 to a 6 and I touched that area and felt a weird lump. I never felt it before and it concerns me. When I get this pain it comes and goes every few months. When its around I deal with it for a day or 2. I would say it's still a 6 painwise on a scale of 1-10. I don't know if it's cancer or what? I haven't gone to see my doctor who performed the procedure about this because in the beginning I thought nothing of it. Any ideas?

[DWilliam85]

I don't know if it's scar tissue, but the 2nd surgery was completed January of 2014. So, it's one whole year later. If it is scar tissue how well do cortisol injections work and how many are usually sufficient to fix the problem? Or would going under the knife again be best and if so would it take 6-8 weeks before I can go to the gym again?

[Dr. Elliot Jacobs]

If your chest looked smooth and flat after the first or second operation, then the lump is most likely scar tissue.  When you had the second operation, the surgeon remove the tissue.  Did the pathology report reveal breast tissue or scar tissue?  That could give you a clue as to what to do.

Dr Jacobs

[DWilliam85]

If your chest looked smooth and flat after the first or second operation, then the lump is most likely scar tissue.  When you had the second operation, the surgeon remove the tissue.  Did the pathology report reveal breast tissue or scar tissue?  That could give you a clue as to what to do.

Dr Jacobs

I was never given a pathology report after both surgeries.  The first time it was done using the Vaser lipo method and one side still looked bigger than the other. Originally, the doctor said Vaser would accomplish more than the cutting under the nipple and removing out the fatty gland. I asked to have it done again with the gland physically removed and I even saw the ugly mess of hard tissue he showed me after. It looked like a big piece of raw meat. The second time was done free of charge and under local anesthesia. I'm in Chicago and don't know if I should see my primary doctor or schedule an appt with my surgeon again for a discussion about it. I read having cortisone or steroid injections might help, but that would take more than one injection. If I'm taking a steroid injection wouldn't my chances of developing gyno again resurface if I'm not taking anti-estrogens?

[Dr. Elliot Jacobs]

I was never a fan of Vaser for gyne unless gland is excised as well.  Some docs claim Vaser removes breast tissue -- it doesn't.  If, after your second procedure, your chest was flat and acceptable to you, then most likely any re-growth within a 4-12 week period is scar tissue.  Going back into surgery for a third time to remove scar tissue will just result in more scar tissue.  If indeed it is scar tissue (best to check with your surgeon about this), then the best treatment is cortisone injections directly into the scar tissue.  It will NOT result in more gyne.  You may need one or more injections spaced roughly 6 or more weeks apart.

Good luck!

Dr Jacobs

[DWilliam85]

I didn't think having surgery to remove scar tissue (if it sounds like scar tissue), would result in developing possible scar tissue again? That's weird...

Any idea or an estimate of what cortisone shots are if you know? The lump isn't noticeable unless it's touched which feels hard. It's under the areola and goes along the scar. So, it's about an inch wide and feels hard and is painful time to time. I would say it also gets itchy sometimes, but I deal more with pain than itchiness.

[Dr. Elliot Jacobs]

I do not charge my patients for any cortisone shots if I have done their operation.

If the lump is feelable but doesn't impact the contours of your chest, then you might just consider watchful waiting.  It may soften and be less itchy in time.  Again, speak with your surgeon for his opinion.

Dr Jacobs

[DWilliam85]

I do not charge my patients for any cortisone shots if I have done their operation.

If the lump is feelable but doesn't impact the contours of your chest, then you might just consider watchful waiting.  It may soften and be less itchy in time.  Again, speak with your surgeon for his opinion.

Dr Jacobs

It doesn't impact my chest as in protruding outward, but yes it's hard and does hurt. I will talk to my surgeon and hope he doesn't charge me for the injections. Thanks for your help Dr. Jacobs! I'll follow up here with how it goes in the future.

[Dr. Schuster]

I doubt it is cancer but of course you should discuss your concerns with your surgeon. Sometimes some scar tissue can develop after surgery. Sometimes a steroid injection of Kenalog can help.

[DWilliam85]

I doubt it is cancer but of course you should discuss your concerns with your surgeon. Sometimes some scar tissue can develop after surgery. Sometimes a steroid injection of Kenalog can help.

Well I setup an appointment with my surgeon and will talk to him about it. Any other suggestions before I see him that I should ask would be greatly appreciated.  Thanks!

[DWilliam85]

Ok so I saw my doctor who did the surgery yesterday and he said the problem is scar tissue. That I need to rub vitamin E into it 3 times a day for a few minutes. He said to this this every day for 3 months. He also said a steroid injection might work but it could change the color of my skin? Anybody here agree with that side effect possibit existing?  The kenalog shot might work or not at all is another thing he said.