How do I tell if this is Scar Tissue or leftover gland??

[Layzie]

My left nipple looks fine but my right is still puffy and I can feel a hard mass underneath it and through the nipple. It is really aggravating, but my surgery was on Sept 16th, so I am unsure if it is scar tissue or residual gland. Any ways I can tell which it is? I did not haveany compression garment.

[Dr. Elliot Jacobs]

You should pose this question directly to your surgeon -- he is in the best position to answer you.

Dr Jacobs

[DrBermant]

My left nipple looks fine but my right is still puffy and I can feel a hard mass underneath it and through the nipple. It is really aggravating, but my surgery was on Sept 16th, so I am unsure if it is scar tissue or residual gland. Any ways I can tell which it is? I did not haveany compression garment.

Six weeks can be very early after surgery with some techniques. 

Posting Standard After Gynecomastia Pictures can help other better understand your concerns.

How Tissues Evolve After Gynecomastia Surgery depend on many factors. Firm tissues after surgery can be residual gland, but also can just be healing tissues or scars.  Different surgical techniques injure tissues to different degrees.  The body typically needs to heal before considering revision surgery. Rushing into secondary surgery can be a mistake unless there are complications that need to be addressed or the next surgery is component of a staged procedure.  Time to tissues softening can vary depending on the original problem, what was done, after surgery care,
Scar Care, After Surgery Compression Garments, and many other factors. Options depend on the problem to be treated. Time can range from 6 months to a year but can vary depending on many issues best explored with your doctor.

I see many patients who complain of residual Puffy Nipple Gynecomastia after another doctor's surgery.  There are many possible problems causing such a deformity.  The most common is remaining gland behind the areola as seen in these Anatomy of Puffy Nipple Drawings.  Check out the images with the link for remaining gland after surgery to see what I mean. 

General Surgeons do not have the same range of sculpting tools for chest surgery as a Plastic Surgeon.

I am about one month post op and am pretty happy with the results so far. I did not have huge gyne, but I was in good shape and the gyne made it look terrible. All in all I had 40 grams removed from my left side and 16 from my right. I developed a hematoma after the surgery as I had no drains but it is gone now. The right nipple is still puffy, but it is going down every day. My chest looks sooo much better than it did and it is awesome. The scars are almost gone! I had my surgery through a general surgeon...

Excision alone has major limitations.  Hematoma After Gynecomastia Surgery can itself distort contour and prolong healing.
 
Even if the doctor achieves a flatter chest, that firm mass does not look like fat, move like fat, or compress like fat.  It just does not move well or look good (especially on animation).  That is why few doctors will show results with chest muscles tightened or arms up over the head or movies showing the tissues in motion.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia Surgery

[Dr. Elliot Jacobs]

I am unsure if it is scar tissue or residual gland.

Some people develop scar tissue fairly quickly after surgery.  Others take longer.  Your doctor will know about how much gland he deliberately left under the nipple.  If he left a bit too much, then you might have a puffy nipple post op.  On the other hand, if he is sure that he took out the appropriate amount of gland, then perhaps it is scar tissue.

If it is scar tissue, then speak to him about possible massage techniques. 

In my patients, if I am convinced it is scar tissue, I recommend massage and if necessary, a kenalog (steroid) injection several months later -- if it has not disappeared with massage.

Dr Jacobs