Indentation/Depression Above Left Areola Post-Op

[t-rex]

I would like to ask the Supporting Doctors regarding my case. I am 8 days post-op now and I have noticed since Day 5, an indentation or depression just above the left areola.The entire left breast is still swelling and bruising, so I can't really tell if this is a crater deformity (which I have read in this site). Will this go away as I heal? Thanks!

[Dr. Elliot Jacobs]

Much too early to tell at this point.  There is swelling everywhere -- and sometimes more swelling in some areas makes a "normal" area look depressed.  ANd at this point there is nothing to do about it.

Best idea is to allow the healing to occur.  Then return to your surgeon to discuss.

Dr Jacobs

[t-rex]

Thank you for your reply, Dr. Jacobs. I'll take your advice. One thing, Doc: Is it advisable to place additional compression in the area where there is void (i.e., the operative site where more mass was extracted)?
Actually, this is the left breast where the indentation/depression occurred and somebody advised me to place a folded cloth over the area before applying the compression vest.

[Dr. Elliot Jacobs]

Obviously I cannot provide specific advice for you.  But in general, smooth compression over the entire chest is advisable.

Dr Jacobs

[Litlriki]

Just to echo Dr. Jacobs regarding smooth, even compression, this is important, since irregular compression can cause deformities in the long term. I have not had a problem with gynecomastia, since the vests provide reasonably even compression, but I have had a couple of liposuction patients over the years who developed deformities as a result of their garments, rather than an issue created during the surgery.  This is most likely because after liposuction, some liquid fat may remain under the skin, and uneven compression can force some of this fat to accumulate above and below a compressed area with a paucity of fat under the compression.  Over time, some of the free floating fat will act as a graft and survive, leaving a valley in the area of compression.  I had this happen with an abdominal binder, where the seam between the panels of the binder dug into the patient, who sat at his desk a little stoop-shouldered post-op.  Similarly, a thigh liposuction patient developed "pockets" of fat in the upper inner thighs where the skin was not compressed above the garment, which was "crotchless" for ease of voiding.  I had to do a touch up procedure to correct this. 

Live and learn...I take extra precaution to avoid these problems now.

Rick Silverman 

[t-rex]

Doctors, thank you for your replies.

@ Dr. Silverman: Thank God, you gave this advise. I applied additional compression yesterday coz somebody advised me to do so. If the worse happens with the additional compression, it would have defeated the purpose of preventing the crater deformity I'm avoiding. How tight should the compression vest be applied? My co-managing surgeon says not too tight because it may cause necrosis of the areol/nipple. Thanks, Doc.

[Litlriki]

The vest should be snug, but evenly so.  Too tight could cause a problem with the nipple, but that would be pretty unusual.

RS