What causes contour worsening as time progresses - pic attached

[platypus768]

Hello Doctors,
    What could be the cause of the following:
    Please see enclosed picture. 6 weeks after my surgery things looked good. 10 weeks after the surgery it seems that the contour is not as tight. Instead of tissues contracting and tightening as I would expect with healing, it seems that they are relaxing or swelling (I cannot tell if it is swelling. There is no scar tissue.). I wore a compression vest for 6 weeks.
Is the cause?:
1) When compression vest is worn tissues are compressed and thus things might look "tighter" immediately after vest is removed.
2) As time progresses tissue "relax" and loosen a bit.
3) When vest is finally removed after 6 weeks the tissues may swell and stay swollen even for another 4 weeks.
   I would very much appreciate your opinions on this.
   Thank you,
    David

Picture is attached.

[Dr. Elliot Jacobs]

You are correct on all three accounts. 

Healing after gyne surgery takes many months -- and there are constant changes.  In fact, the most active healing takes place during the first 4-8 weeks -- when there is still swelling, healing proceeding with scar tissue, etc.

And you cannot dismiss the third party to the procedure, a capricious person call Mother Nature.

That is why one cannot determine the final results of the operation for upwards of 4-6 months after surgery.  Be patient.

Dr Jacobs

[DrBermant]

Hello Doctors,
    What could be the cause of the following:
    Please see enclosed picture. 6 weeks after my surgery things looked good. 10 weeks after the surgery it seems that the contour is not as tight. Instead of tissues contracting and tightening as I would expect with healing, it seems that they are relaxing or swelling (I cannot tell if it is swelling. There is no scar tissue.). I wore a compression vest for 6 weeks.
Is the cause?:
1) When compression vest is worn tissues are compressed and thus things might look "tighter" immediately after vest is removed.
2) As time progresses tissue "relax" and loosen a bit.
3) When vest is finally removed after 6 weeks the tissues may swell and stay swollen even for another 4 weeks.
   I would very much appreciate your opinions on this.
   Thank you,
    David

Picture is attached.

Tissues do evolve after surgery.  I prefer to individually advise my patients how long they will need their compression. One time period does not fit all cases.

Compression Vests After Gynecomastia Surgery do minimize swelling and bruising. They can also protect tissue during activities. How long after surgery they are needed depends on the original problem, what was done, after surgery care, and many other factors. If the chest still swells after removal of the vest, I call this Stage 1: the chest is still benefiting from the garment's protective nature. Pushing healing tissues too soon too far can also result in new damage and swelling. Stage 2 compression is for the scars. Scars that heal under pressure do much better than scars without pressure. Wearing compression garments beyond the protective phase can really improve the final result.

Swelling After Gynecomastia Surgery really depends on the doctor's technique. Some methods cause much more tissue damage and destruction with prolonged swelling and bruising. The progression seen on my site are typical for my patients. That is the advantage of checking your doctor's progression pictures, seeing how their patients evolve after surgery can be a guide to how long your tissues will remain that way.

Hope this helps,

Michael Bermant, MD
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