Very sad feel like dying

[Dghtx832]

Hello doctors. I am 4 months post-op and i am very sad with my results. I can't believe my chest turned out this way. I had a male mastopexy and gynecomastia removal 4 months ago and i never believed this would happen to me. Are these hypertrophic scars? My scars have gone from red to pinkish but have not yet flatten out. I am so afraid that they are keloids and that they will grow even more. My doctor injected me with kenalog 10 today. And we will see how it will work for the next few weeks. He is considering revision surgery if kenalog does not work. I am 22 years old and i dont know what to do. Please advice me.

[Dr. Elliot Jacobs]

These are the typical scars from a peri-areolar mastopexy -- and they are the precise reason why I NEVER do this procedure.  The scars are predictable due to the tensions placed on the wound closure.

Many surgeons, when faced with anticipated skin laxity, may be tempted to do this procedure or another type of breast reduction procedure using techniques commonly used for women. They all produce unacceptable scars for a man.

The truth is that when appropriate surgery is performed by an experienced gyne surgeon, the skin will tighten significantly in most cases, without the need of additional scars to remove lax or redundant skin..

Sorry to tell you now but even with kenalog injections or even a revision, your scars will not be great.

Dr Jacobs

[Dghtx832]

Dr.Jacobs, will they atleast flatten? I'm so dissapointed, why wouldn't a scar revision help this look better?

[Dghtx832]

Dr.Jacobs and if my plastic surgeon does decide to do another scar revision, what should be the proper procedure in which he closes the wound? When i first had the operation he closed the wounds tightly i would say. There was so much tight tension around the areola it was bothersome. Is there a proper technique in which to reduce skin tension? As i feel the skin tension around my areola caused these scars.

[Dr. Elliot Jacobs]

You are correct -- the more tension on the wound closure, the more tendency for there to be scar hypertrophy.  Any further attempt at scar revision (which includes removal of the thickened scar) will result in another closure under tension.  And the result is therefore predictable again.

Best option, to be discussed with your surgeon, would be cortisone injections and.or silicone gel strips to decrease the thickness of the scars.  However, the injections have to be done carefully because they can flatten the scars -- but allow them to spread and widen.

Difficult situation -- so sorry.

Dr Jacobs 

[Dghtx832]

What unfortunate luck of mine. I always considered myself an unlucky fellow and this further proves my bad luck.
Do you think these scars will flatten over time and look less pink and prominent? Or will they always look like this? I know the scar will never fully go away as any other scar but maybe we can make it look somewhat better, isnt that right?
I was reading online somewhere about a different way of closing a surgical site in order to decrease tension , is there such a way? Im asking because my plastic surgeon is considering a scar revision in 4 weeks.  And well final most important question about my chest, will my chest scars always look this ugly ? 

[Dr. Elliot Jacobs]

Yes, there is a way to perform a scar revision -- but it requires the placement of a permanent suture just below the skin, which will be feel-able at all times.  Speak to your surgeon about this.

Yes, the scars will fade in color over time and with some silicone strips or silicone gel plus appropriate cortisone injections, they may flatten out.

Over time, they will become less noticeable but unfortunately all scars are permanent.

Dr Jacobs

[Dghtx832]

Dr. Jacobs i really do appreciate you taking your time to reply to my post.
I been very depressed lately. The kenalog 10 shots i received 2 weeks around my areolas seem to be flattening out the scar and i'm also wearing silicone sheets about 22 hours a day.
Today i noticed another new bad issue with my scars. The skin around the scar and the skin on the scar is turning a dark brown/black color. Is this from the kenalog shot? Can the kenalog shot cause the skin to turn this color? And is it permanent

[Dr. Elliot Jacobs]

The color change MAY actually be blood under the skin and within the scar from the injections -- it should fade away.  Be patient.
Dr Jacobs 

[Dghtx832]

Is it even possible for it to be blood under the skin when the kenalog was injected 2 weeks ago? And i guess , patience is the only thing i can do at the moment. Although playing the waiting game gives me more anxiety

[sparkey]

If all else fails, what about a chest tattoo? 
Something that covers the nipples & scars? 
Don't give up.