Question about swelling/massaging.

[i_dont_know]

As of now, I'm about 6+ weeks post-op. I have some very hard swelling directly underneath each nipple but the swelling varies every day and varies throughout the course of the day. Sometimes the swelling is larger and very solid, other times it's lower and isn't as hard. I try to massage the areas when I feel like it's protruding and very solid to soften it up a bit.. and after massaging the swelling does seem to dissipate a bit and the area becomes softer.. but eventually it returns to the way it was beforehand. I can't really tell if I'm helping the situation or if I should just leave it alone because I'm irritating it or causing minor trauma to the area.

Every few days I put the compression binder back on and sleep with it on... after wearing it for a few hours or a day or so, when I take it off, the area is very flat and there's minimal swelling. But as soon as I leave it off for a while and put a t shirt on, I notice a few hours later that the swelling comes back.

My major questions are these:

- Should I be massaging the area regularly? I can't tell if it's helping or hurting the situation. Sometimes it seems like when I massage it, it softens but then ends up swelling even more an hour or so afterwards. When I leave it alone, the swelling remains but it's not AS solid.

- Is wearing the compression binder every now and then ok? I can't imagine it would be detrimental in any way, but I want to make sure I'm doing everything that will help me heal as effectively as possible.

- What exactly IS the swelling? Is it the remaining glandular tissue that is enlarging? And is this just a temporary part of the healing? Can I expect the swelling to minimize and dissipate for good in the coming months? My chest always looks really good and flat after wearing the binder overnight.. is this what the eventual result will be permanently?

Basically I just want to make sure I'm not aggravating the area or slowing the healing process by putting pressure on the area and massaging it.

Any help and advice from the Doc's would be greatly appreciated.

[DrCALOCA]

Although your doctor is the best person to answer these questions, I do not suggest massaing the area for the first three weeks. Massage can cause bleeding due to breaking of the new vessles that are growing. Weare tha compression garment for at least a month with the last week in the daytime only. Swelling is by definition liquid components of the blood that are located OUTSIDE of the blood vessles, thus causing abnormal increase of volume. When this liquid is absorbed by your body, the swelling subsides. You can expect full recovery in 3 to 6 months, with normal looking scars in up to 18 months.

[i_dont_know]

Although your doctor is the best person to answer these questions, I do not suggest massaing the area for the first three weeks. Massage can cause bleeding due to breaking of the new vessles that are growing. Weare tha compression garment for at least a month with the last week in the daytime only. Swelling is by definition liquid components of the blood that are located OUTSIDE of the blood vessles, thus causing abnormal increase of volume. When this liquid is absorbed by your body, the swelling subsides. You can expect full recovery in 3 to 6 months, with normal looking scars in up to 18 months.

Well, I'm 6 1/2 weeks post-op now so I'm well past the 3 week mark. My PS told me after my 4 week visit that it was OK to massage the area so technically, yes, I know it's probably not hazardous. I just want to know if I could potentially be inducing some of the swelling myself through massages? And also, wearing the compression binder over night every few days definitely flattens my chest out for the time being until I take it off and then the swelling gradually returns. Is it worthwhile for me to keep putting the binder back on every now and then? It can't hurt, can it?

And ultimately, when would be a good timeframe for me to expect the swelling to come to a halt?

[Dr. Elliot Jacobs]

Swelling is very individual.  Wearing a binder or compression garment as long as possible will certainly help -- but there is a point of diminishing returns.

If your binder brings down the swelling and flattens your chest (after all, swelling is simply water), then you might wear it a bit longer.

Massage is meant to mobilize the swelling but too vigorous massage can actually produce swelling.

Ultimately, the swelling will diminish on its own -- be PATIENT.

Dr Jacobs

[DrCALOCA]

It is common to experience some swelling when you discontinue the use of the binder. This is actually normal, even in non operated patietns. Compression reduces the volume caused by liquids in that area. That is why I recommend that you use it only during the daytime, the last week of use. After that, even though you notice swelling it will go down gradually. At 3 to monhts post-op, it should have subsided and you will see the final results of your surgery.

[i_dont_know]

Thanks, Docs. I'm still pretty tender under both nipples. Assuming that's normal, too?

[DrBermant]

As of now, I'm about 6+ weeks post-op. I have some very hard swelling directly underneath each nipple but the swelling varies every day and varies throughout the course of the day. Sometimes the swelling is larger and very solid, other times it's lower and isn't as hard. I try to massage the areas when I feel like it's protruding and very solid to soften it up a bit.. and after massaging the swelling does seem to dissipate a bit and the area becomes softer.. but eventually it returns to the way it was beforehand. I can't really tell if I'm helping the situation or if I should just leave it alone because I'm irritating it or causing minor trauma to the area.

Every few days I put the compression binder back on and sleep with it on... after wearing it for a few hours or a day or so, when I take it off, the area is very flat and there's minimal swelling. But as soon as I leave it off for a while and put a t shirt on, I notice a few hours later that the swelling comes back.

My major questions are these:

- Should I be massaging the area regularly? I can't tell if it's helping or hurting the situation. Sometimes it seems like when I massage it, it softens but then ends up swelling even more an hour or so afterwards. When I leave it alone, the swelling remains but it's not AS solid.

- Is wearing the compression binder every now and then ok? I can't imagine it would be detrimental in any way, but I want to make sure I'm doing everything that will help me heal as effectively as possible.

- What exactly IS the swelling? Is it the remaining glandular tissue that is enlarging? And is this just a temporary part of the healing? Can I expect the swelling to minimize and dissipate for good in the coming months? My chest always looks really good and flat after wearing the binder overnight.. is this what the eventual result will be permanently?

Basically I just want to make sure I'm not aggravating the area or slowing the healing process by putting pressure on the area and massaging it.

Any help and advice from the Doc's would be greatly appreciated.

Scar Care and massaging scars after surgery can help remodel tissues and evolution of scars.  However, trauma can slow healing and cause new swelling. Injured nerves can be hypersensitive, more than the normal amount of feeling. Irritating these nerves can cause more discomfort.  Timing and technique of scar care are best individualized depending on the problem treated, what was done, healing, and other factors best discussed with your surgeon.  If the massaging hurts or causing more swelling, then it is either too soon or too rough.  No pain no gain may work for bodybuilding, but it can slow things down in healing.

After Gynecomastia Surgery Chest Garments can really help with after surgery swelling.    A Stage One Male Chest Compression Garments is safer to get on and off right after surgery.  Swelling without such compression does not go away as fast.  The garment's stabilization of tissues helps minimize new injury and swelling. 

Intermittent compression may be better than no compression, but not as good as full time compression.  This is especially true when periods of no compression result in increased swelling or discomfort.

How long to wear a garment depends on the problem treated, what was done, and other factors best discussed with your surgeon familiar with the problem.  I prefer to individualize how long for each of my patients, one duration does not fit all situations.  As long as there is swelling and a patient is more comfortable with the garment than without, there can be significant advantages to compression.

A Stage Two Gynecomastia Garments help with scars.  Scars that evolve under pressure do much better than scars without pressure.

Not all garments are the same.  Some designs tend to ride up more than others. Fit can be important, that is why I fit each of my patients before surgery.

Hope this helps,

Michael Bermant, MD
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