Going For revision on the 29

[jimmy1234]

I just went to my PS and I booked a revision for the 29th. I had lipo a little over 2 years ago and initially everything went well and looked good. Now my nipples have puffed back out and the bottom of my chest is flabby but not a great deal. i have a couple of questions. First of all, my endo had me taking 50 mg of testosterone cypionate and recently had me stop. I believe this might be the reason for the gyne returning. Secondly my PS said that lipo wasn't neccessary and he could take out the gland with a scalpel and cut inside the areola in his office. Has this type of revision been succesful with anyone?

[glandular]

if you have glandular tissue under the areola making the areola stick out, it definitely needs to be excised as it is firmer and harder than fat tissue.

[Dr. Cruise]

Removal of localized glandular tissue under local anesthesia is reasonable. Most surgeons (myself included) prefer to have their patients asleep as it makes the procedure much more comfortable for both patient and surgeon. If lipo was done in the past, then removal of the glandular tissue under local is not uncommon especially in light of the fact that with revisions both surgeon and patient are trying to keep costs done. In addition to the local anesthesia, ask your doctor to give you something for sedation. I rountinely give my patients some Xanax. It helps relax you so you do not get nervous.

[DrBermant]

I just went to my PS and I booked a revision for the 29th. I had lipo a little over 2 years ago and initially everything went well and looked good. Now my nipples have puffed back out and the bottom of my chest is flabby but not a great deal. i have a couple of questions. First of all, my endo had me taking 50 mg of testosterone cypionate and recently had me stop. I believe this might be the reason for the gyne returning. Secondly my PS said that lipo wasn't neccessary and he could take out the gland with a scalpel and cut inside the areola in his office. Has this type of revision been succesful with anyone?

Revision Gynecomastia Surgery is an art form and can vary in what needs to be done.  I never just excise gland / scar tissue alone and instead prefer my Dynamic Technique which will vary depending on what needs to be done.  You can find Details of Revision Gynecomastia Surgery here.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[jimmy1234]

So everything went ok. The gland did not grow back which is what i had feared buy as it turned out there was a formation of scar tissue that lumped underneath my nipples forcing them to puff out a little. What are the chances of the scar tissue coming back and if so is there anything I can do to alleviate the chances.

[DrBermant]

So everything went ok. The gland did not grow back which is what i had feared buy as it turned out there was a formation of scar tissue that lumped underneath my nipples forcing them to puff out a little. What are the chances of the scar tissue coming back and if so is there anything I can do to alleviate the chances.

Residual gland will look just like scar to the eye (even with surgeon's magnification). Under the pathology microscope, glandular tissue has always been a factor in the many revision surgeries I have done from other doctors.

Scars after gynecomastia surgery depend on the problem to be treated, skills of the surgeon, surgical techniques, Scar Care, Compression Garments, and many other factors.

Prevention is much better when possible.  Some surgeons just damage tissue more resulting in greater swelling, damage, and potential scarring. Prevention of such scars can be a function of choice of surgeon. I prefer techniques the have less swelling, bruising, and easier healing after gynecomastia surgery. It is quite rare that my patients need steroid injections after surgery to manage their scars.  I have seen videos of some doctors' surgery burning away tissue with high cautery settings that make for quicker surgery but more damage.

Patient selection is another factor. Some patients tend to develop such bad scarring, that elective surgery is not a good option.

Such questions are better directed to your doctor who is familiar with the problem and what was done.

Hope this helps,

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

[jimmy1234]

went to my ps today and everything went well. he told me to put some tape on the nipples to keep them flat. he said this will help with the scar tissue coming back but said we would know better in about a years time. Does it take that long for scar tissue to develop?