Scar tissue beneath nipple area causing "puffyness" - after operation

[rattrapbagpack]

During spring 2010 I got a smart-lipo treatment, but I showed pretty much no results as the hard glands were causing nipple puffyness. Later, in early 2011, the glands were removed from both sides. However, 2 days after the operation a blood vessel snapped in my right chest. This caused my chest to fill with flood and swell A LOT. I had to visit ER for an emergency surgery. After this, the right side of my chest was swollen for almost two weeks, before it started to settle down.

Around summer 2011 the scar was healed, but there seemed to be a lot of scar tissue beneath the areola - which again caused puffyness. (But in a different way opposed to pre-op situation, and also my chest is now somewhat asymmetrical.)

I had yet again another surgery in late 2011, where they scraped off the scar tissue. The doctor said there was quite much of it. However, it probably grew back because the result is now only a bit better compared to the previous situation.

Is there any way of reducing the scar tissue, maybe chop it down or something? I've tried massaging, but it hasn't really helped. I'm very happy with my left nipple and I'm hoping there's still some way to fix my right one, but I think I'm running out of options.

These are the pictures of my latest condition, taken last month.

[Dr. Elliot Jacobs]

Sometimes the best treatment of scar tissue is not further surgery, which will heal with -- you guess it-- more scar tissue.  In these situations, when one is reasonably sure that most or all of the sub-areolar breast tissue has been removed, treatment with cortisone injections should be considered.

Speak to your surgeon about this.

Dr Jacobs

[rattrapbagpack]

Big thanks for your reply! When I visited my doctor ~6 months after the latest operation, they had cortisone shots ready. However, they would only consider them for hypertrophic scars and keloids.

I contacted a fellow guy here who seemed to have a similar condition (gynecomastia.org/smf/38/had-cortisone-injection-for-scar-tissue/)
Hopefully I get a reply and get to know how similar his condition was to mine.

[pDiddy2]

Dr. Jacobs is correct. Corisone injections can make a major improvement if done correctly. I had post-op scar tissue on both sides that made me look worse than I did prior to surgery. I flew back to see my dr and had one round of Cortisone injections. Within a week I noticed improvement and after one month the hard, pointy scar tissue was reduced to virtually nothing.   

Check out my User Diary post. I talk all about it. One word of advice; make 100% sure, who ever administers the kenalog or cortisone knows what they're doing. Even if u have to jump on a plain and travel to another state. This stuff is potent and could cause atrophy to healthy tissue.

Best of luck!

[Dr. Elliot Jacobs]

they would only consider them for hypertrophic scars and keloids.

I humbly disagree.  Cortisone will induce atrophy of scar tissue wherever it is injected -- be it on the surface for hypertrophic scars/keloids or deep under the areola for thickened scar tissue.  I have done it too many times to think otherwise.

There are specific techniques and dosages that are required -- the hands that do the injections and the experience of the injector are paramount to getting a good result.  Look carefully for someone who has the experience in doing these injections.

Dr Jacobs

[rattrapbagpack]

Whoa! This is comforting to hear! Big kudos for both your replies. After five(!) operations I was beginning to lose hope, let's hope this is an ace in the sleeve.

What is the difference between Kenalog and cortisone? Is the effect different or are they recommended for different symptoms?

I will consult the doctor who performed the very first surgery for cortisone/kenalog shots later this month.

[Dr. Elliot Jacobs]

Cortisone is the general name for a group of medications -- Kenalog is a specific brand of cortisone.

Dr Jacobs

[rattrapbagpack]

I visited the doctor about a month ago, and he said that he wouldn't consider cortisone shots in my case. The doctor said he was "concerned about a cortisone shot leading to an uncontrolled reaction, which could melt away the fat etc."

I think he might not perform these shots often, or have a lot of experience in giving them or what was the exact reason he didn't consider them safe and worth doing. (He suggested that operation could be an option, but I obviously said no from my past experience.)

If I'm in New York next spring (unsure yet), I'll have to consider booking an appointment! :-)

Cheers and have happy New Year to everyone!