How soon after surgery is it safe to flex chest muscles?

[decimal]

Hello Doctors,

I was wondering how soon after surgery is it safe to flex my pectoral muscles to track my post-op progress?  Or is it counterproductive to the healing process?

When is it safe to raise my arms fully over my head and to the sides without fearing for any disrupted healing?

I am 2 weeks post-op nd have been wearing my compression vest almost 24/7. I take it off for only about an hour once a day everyday to take a shower nd apply neosporin etc.

Thanks

[DrBermant]

Hello Doctors,

I was wondering how soon after surgery is it safe to flex my pectoral muscles to track my post-op progress?  Or is it counterproductive to the healing process?

When is it safe to raise my arms fully over my head and to the sides without fearing for any disrupted healing?

I am 2 weeks post-op nd have been wearing my compression vest almost 24/7. I take it off for only about an hour once a day everyday to take a shower nd apply neosporin etc.

Thanks

Lifting arms up over the head is stressing sculpted tissues.  For my patients I prefer to individualize their return to activity. A specific time frame for all patients may sound great as an anxiety reducing soothing answer, but does not really pan out in the real world (unless you do not mind additional swelling, trauma, and possibly prolonged healing).

The return to activity after surgery depends on the original problem, what was done, skill of the surgeon and many other factors best discussed with your own surgeon. Healing tissues stressed can be further injured. Healing time is lessened when injured tissues are not over stressed. For my patients, peak swelling typically occurs in the operating room. I explain to my patients that comfort is a good guideline for recovery. Recovering from this surgery is like healing a sprain. Pushing that healing tissue with a specific time to resume a specific activity can result in new swelling and prolonged healing.  In bodybuilding no pain no gain. In healing after gynecomastia surgery, ignore the pain and you may just hurt the healing.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Dr. Elliot Jacobs]

One cannot "track progress" by how much your arms can move. 

I instruct my patients to wear the compression garment for at least 3-4 weeks.  And also to avoid all strenuous physical activity for the same time frame.  However, they are allowed to move their arms slowly -- at all times and in all directions.

Dr Jacobs

[decimal]

I am 4 weeks post op now. Apart from heavy loose skin showing up under my areolar region that gets exacerbated when I flex my muscles, I have a sharp pulling pain when I extend my arms over my head and stretch.

The pain is from a region under my pectorals, that lies at the periphery of the area that was liposuction. What could this mean?

I asked my doctor over email, and was told that "feeling of pull is normal and will not harm and will gradually subside." I intend to have myself physically examined by him anyways just to be on the safe side.

Regarding the loose skin, I am hoping that it will contract back to a state acceptable for my age and fitness level, considering that I am just 24 yrs old, and have had a constant healthy weight for the past 7 years. I have attached before and after pictures of my problem. The loose skin just does not show up in pictures no matter how hard I try, but is very very noticeable when I look at myself in the mirror.

Dr Jacobs and Dr Bermant, I would highly your opinion on the above.

Thanks

[Dr. Elliot Jacobs]

A pulling or tight sensation is not abnormal at this stage after surgery.  For my patients, I allow some early stretching at four weeks -- but I would defer to your own surgeon's post-op care regimen.

As for loose skin after surgery, it is probably somewhat better than prior to surgery.  Loose skin is usually due to a prior overweight condition.  The skin stretches and loses its ability to tighten significantly after surgery.

There is nothing to do at this point.  I would recommend waiting for at least 5-6 months or more after surgery.  Then re-evaluate any residual loose skin with your surgeon and inquire what options you would have to tighten the remaining loose skin.

Best of luck!

Dr Jacobs

[DrBermant]

I am 4 weeks post op now. Apart from heavy loose skin showing up under my areolar region that gets exacerbated when I flex my muscles, I have a sharp pulling pain when I extend my arms over my head and stretch.

The pain is from a region under my pectorals, that lies at the periphery of the area that was liposuction. What could this mean?

I asked my doctor over email, and was told that "feeling of pull is normal and will not harm and will gradually subside." I intend to have myself physically examined by him anyways just to be on the safe side.

Pain after surgery depends on the problem to be treated, what was done, surgical techniques, skill of the surgeon, after surgery care, After Gynecomastia Compression Garments, and many other factors. 

After surgery pain has two components, the initial discomfort, and longer term discomfort. 
The initial comfort is a factor of tissue swelling, bruising, and if the pain cycle gets a chance to start.  Longer term pain is usually from recovering injured nerves or nerves trapped in scar tissue. This can be something like a nerve in your arm waking up after being "asleep."  Pulling on a recovering nerve tends to be uncomfortable.

I prefer techniques that help healing after gynecomastia surgery.  This means minimizing Bruising, Swelling after gynecomastia surgery.  These are typical results, I work very hard and enjoy when my patients tell me that their results were just like or better than what they saw on my website.

Although I prescribe a strong pain medication for each of my patients, they usually tell me that plain Tylenol alone is more than enough to manage comfort and pain after gynecomastia surgery. They tell me it feels like they just had a heavy workout and their chest is sore.  Long term, my patients will describe a little pulling sensation or hypersensitivity. It is rare that one of my patients will use the word pain for the long term sensations.

How much tissue is injured really depends on the tools and skills of the surgeon. Such injury is a major factor in why I do not use sharp cutting cannula, ultrasonic, vasor or other blind techniques to what tissue is being damaged. I perform a great deal of Revision Gynecomastia Surgery on patients unhappy with another doctor's results. Almost all patients tell me that there was no comparison after my surgery from their prior misadventure(s), especially in their comfort after surgery and recovery.

Each doctor has his / her own methods and you should check out their patients' description when possible.  This forum has some experiences that may reflect what any particular surgeon tends to achieve. 

Regarding the loose skin, I am hoping that it will contract back to a state acceptable for my age and fitness level, considering that I am just 24 yrs old, and have had a constant healthy weight for the past 7 years. I have attached before and after pictures of my problem. The loose skin just does not show up in pictures no matter how hard I try, but is very very noticeable when I look at myself in the mirror.

Dr Jacobs and Dr Bermant, I would highly your opinion on the above.

Thanks

These Standard Pictures for Male Chest Lift and Loose Skin of the Male Chest help demonstrate issues of ptosis (drooping) and excess skin of the male chest. 

Excess skin of the male chest can deform the contour.  Skin reduction scars can be a compromise that must be weighed in comparison to how bad the loose tissues and the appearance of Low Nipples on a Male Chest.  Make certain you look for examples of that specific doctor's skills, this operation, in the wrong hands can create a disaster such as this Large Areola Complication of Bad Male Mastopexy Surgery.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia of Male Chest Ptosis - Sagging and Male Mastopexy Chest Lift Sculpture

[decimal]

I had my surgeon examine me yesterday, and he said that the pulling sensation(you could call it pain, if I try to ignore the sensation and try to stretch too far) was probably coz of some regrowing nerve that attached itself to the wrong spot after liposuction. Over time, it should fix on its own.

Does that sound rite to you gentlemen?

Thanks

[Dr. Elliot Jacobs]

Sometimes there can be scar tissue that forms in/around a sensory nerve.  Other times, the presence of scar tissue holding tissues tight can produce a similar sensation.

Time, gentle massage and gentle stretching are all helpful.  Finally, down the road, if there is still pain, then sometimes a careful injection of a steroid into the area of pain can be helpful.

Dr Jacobs

[decimal]

Thank you so much for your advice doctor.

I started massaging the area and just within 3 days the pain/pulling sensation was 95% gone!! Its amazing how I was worried over nothing!