Scar tissue blob behind nipple. (~1 yr post revision surgery w. Dr Lista)

[throwaway321]

If anyone can listen/offer some advice I would greatly appreciate it:

After my gyno surgery with Dr. Lista in early-mid 2015 I developed a 'rubbery' texture blob of what my Dr said was scar tissue behind one of my nipples that just didn't want to go away with time. I was assured this was normal and was advised to massage that area daily multiple times until it went away, I followed my Dr's advice obsessively in hopes of getting rid of this scar tissue, but to no avail.

Because I was unsatisfied with the result, the following year Dr. Lista agreed to conduct a corrective surgery to try and get rid of the remaining tissue,  he warned me there is a possibility he couldn't make it any better. Very quickly, (1-2weeks) after the revision surgery I quickly noticed a similar blob (perhaps the same) but smaller in size behind my nipple once again, and again was told it was normal and to continue massaging my chest. After the 3rd post-op appointment the build up in my chest became slightly worse than it was even before the revision surgery. At this point, Dr. Lista told me there was nothing that could be done to eliminate the scar tissue and that I was likely to live with it for the rest of my life, but he still advised me to continue massaging daily.

It has been close to a year now after my revision surgery, and I'm still continuing to massage my chest daily but with no progress, in fact, it almost feels like maybe it has made the scar tissue grow slightly more.

Is there really nothing that can be done? I mentioned the steroid injection procedure to Dr. Lista, but he said it's a really bad idea and that 'it would only make things look even worse'.

The amount of scar tissue is somewhat minimal, but you can quite clearly pinch and grab and tug on the blob behind my nipple and it is visible. The texture of it feels very similar to the small strawberry shaped gland I had before any of my surgeries, and it is making me moderately worried that maybe the gland wasn't fully removed all along.

I find myself having the same problem as before when I had gyno with the only difference that this time it's only 1 of my nipples that noticeably sticks out from my clothing, and it drives me crazy, to the point where I cannot stop obsessing over my chest in most clothing and feel very uncomfortable in my own skin. It's like I can feel that the left side of my chest is tighter/wrapping around my nipple as its poking out. Ughh...

Is there no other procedure, medication, or anything else that can help me get rid of this scar tissue? Is it possible that massaging daily can make things worse? When I asked Dr. Lista he assured me that massaging daily will not make my scar tissue grow larger. Should I see another doctor and get their opinion? Is it possible that maybe there is still leftover gyno and not actually scar tissue? Is there a test that can be done to see if truly is scar tissue?

If anyone could help me or give me any advice I would be grateful.

Thank you!

[Dr. Elliot Jacobs]

Dr Lista has a fine reputation and I  would strongly recommend following his advice.

Yes, cortisone injections (which I often do) are the best treatment for scar tissue -- but they are very potent and if done incorrectly, can result in problems (craters deformities, de-pigmentation, thinning of the skin, etc) that are not treatable.  Sometimes, if there is just a very minimal amount of residual scar tissue, I recommend against any cortisone treatment.  That may be the situation that you are in.

I have had some patients who complain about scar tissue because they can "feel" it after their surgery.  Understand that the body naturally heals with scar tissue -- and it's presence under the nipple or elsewhere on the chest is not a poor result from surgery but rather a normal part of the healing process.  I often tell my patients that the surgery is performed so that you look better -- it is not performed so that you can pass the "feel my nipple and tell me if you feel something" test.

Hope this helps.

Dr Jacobs

[throwaway321]

Dr Lista has a fine reputation and I  would strongly recommend following his advice.

Yes, cortisone injections (which I often do) are the best treatment for scar tissue -- but they are very potent and if done incorrectly, can result in problems (craters deformities, de-pigmentation, thinning of the skin, etc) that are not treatable.  Sometimes, if there is just a very minimal amount of residual scar tissue, I recommend against any cortisone treatment.  That may be the situation that you are in.

I have had some patients who complain about scar tissue because they can "feel" it after their surgery.  Understand that the body naturally heals with scar tissue -- and it's presence under the nipple or elsewhere on the chest is not a poor result from surgery but rather a normal part of the healing process.  I often tell my patients that the surgery is performed so that you look better -- it is not performed so that you can pass the "feel my nipple and tell me if you feel something" test.

Hope this helps.

Dr Jacobs

Thank you for your reply Dr Jacobs, and yes I understand Dr Lista is a reputable surgeon, he also shared your "not a feel my nipple and tell me if you feel something test" sentiment, but it is not the case. There is a visible difference that I am unsatisfied about, where the left side of my chest and nipple area is sticking out of my clothing, even if to the outsider it may seem minimal, it is bothering me a great deal. It's not like I'm obsessing over the other side of my chest where I am very happy with the final result in the same way with the side with scar tissue, you know?

So given my adamancy to get this fixed, do you recommend  I seek out a surgeon that does cortisone injections? Or are there some other alternatives that can be explored?

Again, really appreciate your reply, Doc.

[Dr. Elliot Jacobs]

Assuming that Dr Lista removed all the breast tissue, then the only possible reason for what you are feeling/observing is the new development of scar tissue.  And yes, proper injection of cortisone would probably be of help.

Recommend you visit a surgeon in your area who does these type of injections.  There are really no other alternatives.

Dr Jacobs

[throwaway321]

Assuming that Dr Lista removed all the breast tissue, then the only possible reason for what you are feeling/observing is the new development of scar tissue.  And yes, proper injection of cortisone would probably be of help.

Recommend you visit a surgeon in your area who does these type of injections.  There are really no other alternatives.

Dr Jacobs

Is there any test that can be done to know for sure if all the breast tissue has been removed?

Thanks again

[Dr. Elliot Jacobs]

Sorry, there is no test available.  However, your surgeon should be able to tell you how much, if any, breast tissue remains.

Dr Jacobs