6 weeks post op - asymmetrical chest/nipples

[Colorado Kid]

I'm hoping I might get some clarification on these issues.  Any input would be great.  I'm six weeks post surgery and I've noticed a couple of things that concern me....

1. My right aeola is convex and my left is alinged with my chest as it probably should be (not convex nor concave). 

2. My right chest is slightly larger than my left side (the left side seems to be taking pretty good shape).  Overall much happier with how the left side has turned out.

3.  My chest hasn't taken on normal shape it seems, yet.  It seems the area immediately below my chest muscle is sort of "choppy" for lack of a better word.  The surface of the skin is not smooth.  You can see dips and such.  Is this typical? 

I'm wondering if scar tissue may be the reason for some or all of these issues?  Can scar tissue build up to the point that it causes one side to be larger than than the other.  Can scar tissue build up under the aoela.  How long does scar tissue typically last?  Just seems strange to me that one side hurt less, is shaped better, and the incision is much cleaner meaning you can't hardly see any type of incision being that it was cut along the aoela.  For some reason, the opposing side incision extended further than the aoela and into my skin approximately a sixteenth of an inch.  Is this normal?  I would imagine the incision would be very important to a plastic surgeon and placement would be very well thought out?  Would there be any excuse for why this didn't occur?  My doctor said the incision would not intrude into any other area besides the aoela. 

Again, any input would be great.

Thanks in advance!

Colorado Kid

Oh, one more question, at what point may I expose my chest to sunlight for extended periods of time?

[Litlriki]

It's a little difficult to analyze your situation without knowledge of how you looked pre-op, what took place intra-operatively, and without photos of your current appearance.  From your description, my curiosity is raised as to whether you might have had some bleeding or other issue during the surgery that required opening the incision further (or stretching it with retraction), which would account for the difference in the appearance of the scar/incision site.  If there was some bleeding on that side, it might also account for prolonged swelling as compared to the other side.  If that is the case, then more time waiting on a final result may allow for resolution of some of the things that you described in terms of asymmetries. 

The alternative is that the resection from right to left was carried out in a different manner on one side versus the other.  Generally, one would anticipate that the operation is done the same way on the right and the left, with minor modifications to manage issues related to handedness, unless the surgeon is completely ambidextrous.  Such minor modifications, however, shouldn't lead to a completely different result. 

Scar tissue is forming in the operative site, but again, one would anticipate that the tissue would scar in a similar manner on both sides, unless the operative process that generated that scar tissue was different from side to side.  You can modify the process during scar formation with massage and compression

As far as sun protection, I recommend sun protection of scars for a year, so that they don't darken.  Sun exposure to the chest is reasonable after four to six weeks in order to allow for all of the bruising to resolve, since sun exposure to bruised areas can leave them dark.

At this point, you need to ask your surgeon for more detailed management instructions, and perhaps get a perspective as to why things are so asymmetric.  He or she should be to give you a more informed response.

Good luck,

Rick Silverman

[Colorado Kid]

Your input is much appreciated, Dr. Silverman.