what is that? gland,fat tissue or just swelling?

[khan]

hello doctors,
i'm 4 week post op. I took my pills regularly,i still have to wear compression band for next 2 weeks. before operation my surgeon told me that only incision is not enough,there must be a lipo suction done. he also told me that my left side needs more attention.
on second consultation(post op) he tells me that i am facing a lot of swelling.
i grab that area and point him,he replies it is fat and he would not make a dent in my chest. now, for some reasons it is hard to believe that this is just fat,when my arms are down(normal standing position) this thing is horizontal, and if i lift my arms up it is vertical,as you can see in the pictures.i hope doctor is right, it is not that big issue and it will go away. but it does not feel like a normal body fat it is hard, that makes me worry

besides i never had a flat chest since the first day post op.


front view arms on hips


right side


left side




both arms on hips muscle tight

[Dr. Elliot Jacobs]

Four weeks is just too early to make a judgment on the final result.  It may be that there is residual fat and gland tissue -- but it may also be that you have significant swelling.

Best to tone down your concern and wait it out -- give it at least 4-6 months to achieve full healing -- and then if you still have residual excess tissue, you should return to your surgeon for a discussion about it.

Dr Jacobs

[khan]

Thanks Dr. Jacobs

[DrBermant]

hello doctors,
i'm 4 week post op. I took my pills regularly,i still have to wear compression band for next 2 weeks. before operation my surgeon told me that only incision is not enough,there must be a lipo suction done. he also told me that my left side needs more attention.
on second consultation(post op) he tells me that i am facing a lot of swelling.
i grab that area and point him,he replies it is fat and he would not make a dent in my chest. now, for some reasons it is hard to believe that this is just fat,when my arms are down(normal standing position) this thing is horizontal, and if i lift my arms up it is vertical,as you can see in the pictures.i hope doctor is right, it is not that big issue and it will go away. but it does not feel like a normal body fat it is hard, that makes me worry

besides i never had a flat chest since the first day post op.

4 weeks can be very early after surgery with some techniques.

Posting Standard After Gynecomastia Pictures can help other better understand your concerns.

How Soon Do You See Results After Gynecomastia Surgery depends on many factors, we tend to see instant results for my patients.  However, I prefer to optimize Healing After My Male Chest Surgery such that early results are possible.

As with any injury, surgery needs to heal. This is not just at the surface, but throughout the sculpted region.  Just like any cut, healing tissues tend to start out firm. Firm tissues after surgery can be residual gland, but also can just be healing tissues or scars.  Different surgical techniques injure tissues to different degrees. Time to tissues softening can vary depending on the original problem, what was done, after surgery care,
Scar Care, After Surgery Compression Garments, and many other factors. Options depend on the problem to be treated. Time can range from 6 months to a year but can vary depending on many issues best explored with your doctor.

I see many patients who complain of residual Puffy Nipple Gynecomastia after another doctor's surgery.  There are many possible problems causing such a deformity.  The most common is remaining gland behind the areola as seen in these Anatomy of Puffy Nipple Drawings.  Check out the images with the link for remaining gland after surgery to see what I mean. 

Liposuction is great for fat, but does not do well for gland at all.  As shown in the anatomy link, there are usually fingers of gland between fingers of fat.  Liposuction no matter what technique (sharp cutting cannula, specially designed cannula, ultrasonic, laser, or "smart") targets the fat first.  Remove the fat and the gland remains behind condensing the fingers making a firm mass.
 
Even if the doctor achieves a flatter chest, that firm mass does not look like fat, move like fat, or compress like fat.  It just does not move well or look good (especially on animation).  That is why few doctors will show results with chest muscles tightened or arms up over the head or movies showing the tissues in motion.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia Surgery

[khan]

Thank you Dr. Bermant.
I am going to see my surgeon next week