Evolution after surgery

[fnnewguy]

Hey Docs, I have been reading alot of stories about guys having flat nipples then puffing out again, then going back to normal. Right when I took the bandages off everything was flat even though it looked like the nipple was kinda smashes down into it self. Now they are slightly puffy, with a crease. My surgeon said that as the skin tightens it will correct itself. When I flex I can feel almost like firm fluid near the operating area, is this swelling? IS this kind of evolution normal?

[Litlriki]

It is normal for the "button" of tissue left behind under the areola to swell during the healing process.  This may take a few weeks to get to the worst degree, and then it takes a while to resolve.  This may have to do with recovery of the normal microvascular blood flow, as well as swelling related to the inflammatory process which is an integral part of wound healing.  In patients who start with very minimal gynecomastia, the swelling may actually seem worse than the original condition, so patience is required as this resolves.

Rick Silverman

[fnnewguy]

 Thanks doc. Yeah I'm a muscular guy who just had large puffy nipples. What about the creases? Do you see that in any of your patients? Will it go away as the skin tightens?

[Litlriki]

Sometimes when the areolae are really large, there may be some redundancy afterwards, which can result in creases.  I can't say that I've had to do anything to treat these with any frequency, so they usually resolve over time, at least to a point where they no longer bother the patient.

RS

[fnnewguy]

Thanks. It's right between the incision and the nipple. It seems to get better as the days go by. It's not as easy to be patient as I thought it would be.... I also had an issue where the entire Areola scabbed over and was far more painful than the surgery... Also I'm at 2 weeks, I have been weari g a binder day and night Nd just got a size too small under armor shirt. It feels tight but not the same amount of compression. Would you suggest wearing the binder for another few weeks?

[DrPensler]

With respect to scar there is increased deposition of collagen and proliferation of new blood vessels for approximately four weeks. After four weeks all of the building blocks are in place and your body slowly reorganizes what is there over several months.