Nipples still protruding outwards/Puffy

[chadhakimian]

My PS at Kaiser said he could not feel any hard lumps in my chest so he came to the conclusion that I had Pseudogynecomastia and recommended liposuction as the best treatment option. I am almost 21 years old and my body fat is around 14-15% so I am not an overweight guy by any means. After working an extra job for a couple years and having enough money for the procedure I finally went through with it. I went through with this procedure because my nipples slightly protruded outwards or were "puffy" and were always visible through a shirt. Now, almost four weeks later, my chest is a bit flatter but my nipples are still protruding outwards/puffy and are still visible when I wear a T shirt. I am starting to worry if enough was lipo'd out or even if Lipo was the best option. So I guess what im trying to ask is was this procedure a failure and was lipo the best option because my nipples have been protruding outwards like they are now (almost 4 weeks) as they were on day 3 post opp and even before I got the procedure?

[Dr. Elliot Jacobs]

When a patient tells me he has puffy nipples (and describes it accurately), that tells me that there is some amount of solid breast tissue just beneath the areola.  Standard lipo instruments just simply cannot remove that breast tissue adequately.  Certain sharp specialized instruments, can, on occasion, do the job.  

In your case, you are in the midst of healing so you cannot pass judgment on the ultimate results of your surgery.  Best to wait 4-6 months and then have another talk with your surgeon.

Dr Jacobs

[chadhakimian]

[font="Open Sans", sans-serif]Thank you Dr. Jacobs![/font][/color]
I had a hunch that my issue was caused by excess breast tissue but my surgeon said said otherwise because he could "not feel any hard lumps". I am hoping when I see him in a couple weeks and he examines the results (or lack of), he will maybe consider performing a revision procedure consisting of excising breast tissue after a few months if things do not change. I have heard surgeons do not 100% know what they're working with until they get inside, is this true? Also, assuming my surgeon (or a different one) agrees to a revision procedure, what would be an appropriate time period to wait before having a revision procedure done?
Thank You Very Much!

[Dr. Elliot Jacobs]

It would be wise to delay consideration of any revision surgery for at least six months or longer.

And yes, the surgeon doesn't really know the extent of gland until he/she is actually operating.  Even my experienced hands cannot tell the presence of gland vs hard fat (yes, it does exist) until I actually in the middle of surgery.

Good luck!

Dr Jacobs