Are the puffy nipples back for good.

[winston001]

Hi.

I am a couple ofdays short from being 5 weeks post op, there is still some swelling from fluid I am told by my surgion who I saw a few weeks back.
I've noticed the other day though that when it is warm my nipples look puffy again as they did pre-op, but if it's cold they will go flat, the same problem I had pre op.
This problem seemed to happen over night as before this they looked flat in a hot room or a cold room.
Could this puffyness just be from the remaining swelling and fluid retention or maybe scar tissue or should I be concerned.
As I say a few days ago my nipples looked flat and I was happy with how it was looking but now I'm worrying the gyne could be coming back.
Is it commen for the nipples to go puffy post op from the healing process.

My condition before operation: mild Gynecomastia causing puffy nipples, excition to remove.

Thank you for your time, just need some reassurance please.

[Dr. Cruise]

Every surgeon has there own way of handling this problem. Increased swelling 5 weeks out may represent healing scar tissue or possible fluid accumulation. You should see your surgeon. If there is a seroma this should be drained. Seromas are cavities filled with fluid. Remember, during the surgery a cavity is created by removal of the breast tissue. If it is healing scar tissue injecting the scar tissue with Kenalog ( a corticosteroid) often is very helpful at flattening it out relatively quickly. The kenalog does two things. 1) I causes swelling to go away quicker and 2) It causes the scar tissue that is forming to soften and go away quicker. Once again, this is just how I would handle it. Either way seeing your surgeon would be useful.

[DrBermant]

Hi.

I am a couple ofdays short from being 5 weeks post op, there is still some swelling from fluid I am told by my surgion who I saw a few weeks back.
I've noticed the other day though that when it is warm my nipples look puffy again as they did pre-op, but if it's cold they will go flat, the same problem I had pre op.
This problem seemed to happen over night as before this they looked flat in a hot room or a cold room.
Could this puffyness just be from the remaining swelling and fluid retention or maybe scar tissue or should I be concerned.
As I say a few days ago my nipples looked flat and I was happy with how it was looking but now I'm worrying the gyne could be coming back.
Is it commen for the nipples to go puffy post op from the healing process.

My condition before operation: mild Gynecomastia causing puffy nipples, excition to remove.

Thank you for your time, just need some reassurance please.

5 weeks can be very early after surgery with some techniques.

Posting Standard After Gynecomastia Pictures can help other better understand your concerns.

Early after surgery swelling can mask residual deformity. As the swelling resolves, remaining gland can stand out.  Subtle puffy nipple deformity can also be flattened by the thin skin muscle under the areola such as in a cold room. When relaxed again, the contour again shows through.

How Tissues Evolve After Gynecomastia Surgery depend on many factors. Firm tissues after surgery can be residual gland, but also can just be healing tissues or scars.  Different surgical techniques injure tissues to different degrees.  The body typically needs to heal before considering revision surgery. Rushing into secondary surgery can be a mistake unless there are complications that need to be addressed or the next surgery is component of a staged procedure.  Time to tissues softening can vary depending on the original problem, what was done, after surgery care,
Scar Care, After Surgery Compression Garments, and many other factors. Options depend on the problem to be treated. Time can range from 6 months to a year but can vary depending on many issues best explored with your doctor.

I see many patients who complain of residual Puffy Nipple Gynecomastia after another doctor's surgery.  There are many possible problems causing such a deformity.  The most common is remaining gland behind the areola as seen in these Anatomy of Puffy Nipple Drawings.  Check out the images with the link for remaining gland after surgery to see what I mean. 

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia Chest Sculpture

[winston001]

Thanks for replying, I guess it is still early days yet but you have helped put my mind ease. My surgion has assured me it's just fluid and will go over time it's just unfortunate you never know how long it's going to take 2 months, 3 months, just have to be more patient from now on.

Thanks again.