Swelling or scar tissue.

[Gynod]

Hi. I had surgery 3 weeks ago in another country - excision and liposuction were performed.
The day after surgery my chest looked really flat, however, 3 days later when I went back to my surgeon ( i stayed abroad for 6 days) my chest had filled with fluid. So my surgeon proceeded to drain the fluid, then found the chest was all hard and quite enlarged, so she began to push down on these hard parts (she pushed down really hard, as she said it was all scar tissue). She did the whole left side and began on the right, but didn't do anywhere near as much because of the obvious discomfort i was in.
She then told me I need to massage the chest untill all the hardness goes away and drain the fluid myself if necessary when i got home.
Needless to say i wasn't too pleased about doing either which i told her but she said it needed to be done, so i have been draining the fluid myself using a sterile needle and sterile syringe, as on a few occasions the fluid build up was quite substantial (around 70ml on one side once). I haven't started massaging yet though as i feel really uncomfortable doing it while my chest is so tender.
At around 1 week post surgery, my chest has gone back to approximately the size it was before surgery. The left side is bigger than the right (thats the side the surgeon massaged).
I went to see my GP last week, who has performed gynecomastia surgery in the past, and he seemed to think my surgeon was wrong about it being scar tissue, and that it was just inflammation that should go away itself.
My question is in your opinion do you think a few days after surgery is too early for scar tissue to build up, therefore it is just swelling that should subside itself? Whatever it is has made both side of my chest quite hard all over the operated area.
All responses from the resident doctors are welcome and appreciated, especially Dr Jacobs, Dr. Silverman and Dr. Pope.
Many thanks in advance.

[Dr. Elliot Jacobs]

Obviously I can't comment on your case in specifics.

However, the normal and expected process of healing after surgery involves "induration" -- which is firmness. This is not scar tissue and it occurs even in uneventful cases.  I always tell my patients to expect induration to set in sometime within 1-3 weeks after surgery.  And it remains for a month or two before it begins to soften up.

Dr Jacobs

[Litlriki]

It's not clear to me what's going on with your chest.  I don't understand where all of the fluid you're draining is coming from. Induration, as described by Dr. Jacobs, is normal, and sometimes, patients will feel lumps in the operative site related to this induration, which can be irregular.  Actual collections of fluid, however, are not common, especially after an uncomplicated procedure, so I'm not sure what's causing them.  "Scar tissue" is something that forms over time, not something that appears three days after surgery. 

I think you may have saved some money by traveling abroad for your surgery, but you may end up spending more and putting in a lot of time to correct whatever may have been done. I hope for your sake that it resolves uneventfully and leaves you with a satisfactory result.

Good luck,

Rick Silverman

[Gynod]

Firstly, thanks for the replies Dr Jacobs and Dr. Silverman.

During the induration stage, is it common for the chest to reach the size it was before surgery (because immediately after surgery my chest was completely flat, then within a week it went back to the size it was before surgery, which is how it has stayed)?

Dr. Silverman, a few other forum members who have been to the same surgeon have had fluid build up too, they've posted their stories in the europe section. The fluid is thinner than blood, so can only assume they are seromas (obviously i'm not qualified at all, just assuming from reading up).

[DrPensler]

swelling persists for months postoperatively. When I perform liposuction I tell patients it takes several months to see the final results.

[Gynod]

Many thanks Dr. Pensler.
Generally, when patients experience swelling/induration as i have, would you still recommend they massage at around 4 or 5 weeks, or is it best to wait till the swelling/induration subsides?