revision 3 months post op

[azndan]

First off, this site has been a ton of help. Everyone's questions and answers and advice and opinions are very much appreciated.
My first surgery left gland behind which caused me to have a flat chest with puffy nipples. I had a revision in march with a different doctor and he removed all the gland and did more lipo. Just like the first surgery I was flat as a board during the first week. It was a good kind of flat. It was perfect and didn't look deflated or anything. I knew it would eventually swell up and it did so I wasn't surprised or worried. At 3 weeks I went for a checkup and he told me I can stop wearing the vest and could start jogging again. When I ran everything jiggled and it would swell up really bad but when I went to bed it would be flat again in the morning until I started moving around again. This went on and on for weeks and now I'm at the 3 month mark and everything still seems "jiggly". I have a defined chest when I flex but when I relax it's like a water balloon. I have a little internal scar tissue which causes a slight point to my chest but from what I read it will go away one day. (I hope) It's no longer puffy, just pointy. Also, it's still tender and numb. Some days are worse than others. I see where different doctors say wait so many months, some 2-4, some 3-6, and some say wait a year! I know those are different estimates because everybody is different but what do you think the real actual number is? Can there be swelling at this point? It's like my chest is soft and mushy. Very very soft, even softer than a womans. It feels like nothing is in there, but not hollow either. It's very hard to explain but it's almost like I'm back to my pre-op shape except there's no gland or fat in there. Has anyone else's chest ever gotten back to how it looked the first week post op? Or is this something I have to deal with again?

[gyn9]

Hey

You have exactly the same issue as me, I had mine 4 years ago and now they seem to have retunred, only this time its not dense fatty tissue just hollow under the skin?

Also my areolas have been strtched so much from the gland they seem to sag over and point out, im thinking of going back for revision

[azndan]

I'm going to ask my PS about that laser skin tightening. I don't know if it's possible to use it after lipo or what but I know women can have their breasts tightening so why can't it work with a guy?
He told me all of my swelling SHOULD be gone by now. I know they tell you to have realistic expectations, and I do, I really do, but now it's almost like i have gyne even though I don't because of the jiggly skin and scar tissue puffing out my nipples.

[DrBermant]

First off, this site has been a ton of help. Everyone's questions and answers and advice and opinions are very much appreciated.
My first surgery left gland behind which caused me to have a flat chest with puffy nipples. I had a revision in march with a different doctor and he removed all the gland and did more lipo. Just like the first surgery I was flat as a board during the first week. It was a good kind of flat. It was perfect and didn't look deflated or anything. I knew it would eventually swell up and it did so I wasn't surprised or worried. At 3 weeks I went for a checkup and he told me I can stop wearing the vest and could start jogging again. When I ran everything jiggled and it would swell up really bad but when I went to bed it would be flat again in the morning until I started moving around again. This went on and on for weeks and now I'm at the 3 month mark and everything still seems "jiggly". I have a defined chest when I flex but when I relax it's like a water balloon. I have a little internal scar tissue which causes a slight point to my chest but from what I read it will go away one day. (I hope) It's no longer puffy, just pointy. Also, it's still tender and numb. Some days are worse than others. I see where different doctors say wait so many months, some 2-4, some 3-6, and some say wait a year! I know those are different estimates because everybody is different but what do you think the real actual number is? Can there be swelling at this point? It's like my chest is soft and mushy. Very very soft, even softer than a womans. It feels like nothing is in there, but not hollow either. It's very hard to explain but it's almost like I'm back to my pre-op shape except there's no gland or fat in there. Has anyone else's chest ever gotten back to how it looked the first week post op? Or is this something I have to deal with again?

3 months can be very early after surgery with some techniques.

Posting Standard After Gynecomastia Pictures can help other better understand your concerns.  If loose skin is an issue then these Pictures to Evaluate Loose Skin on the Male Chest can help with significant drooping.


Early after surgery swelling can mask residual deformity.  How Tissues Evolve After Gynecomastia Surgery depend on many factors. Firm tissues after surgery can be residual gland, fat, but also can just be healing tissues or scars.  Different surgical techniques injure tissues to different degrees. 

I see many patients who complain of residual "Swelling" 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. 

Here are just a few of the many examples I have seen and treated:

• Revision Gynecomastia After Failed Liposuction By Other Surgeon
• Revision Puffy Nipple Gynecomastia After Failed Liposuction By Other Surgeon
• Revision Gynecomastia After Liposuction and Partial Gland Excision By Other Surgeon.
• Revision Gynecomastia After Partial Gland Excision
  

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'm going to ask my PS about that laser skin tightening. I don't know if it's possible to use it after lipo or what but I know women can have their breasts tightening so why can't it work with a guy?
He told me all of my swelling SHOULD be gone by now. I know they tell you to have realistic expectations, and I do, I really do, but now it's almost like i have gyne even though I don't because of the jiggly skin and scar tissue puffing out my nipples.

Laser skin tightening does not work well. Look for actual before / after pictures and video to see if this technique really works as claimed before trying. Ask about scar issues especially on the chest and pigmented areola.
Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia Chest Sculpture

[azndan]

Laser skin tightening does not work well. Look for actual before / after pictures and video to see if this technique really works as claimed before trying. Ask about scar issues especially on the chest and pigmented areola.
Hope this helps,

Is there anything that can actually help? I'm not gonna believe all those tv miracle creams or stuff I see on the internet. My doctor gave me the go ahead to start exercising 3 weeks postop and that's what I have been doing for the past 5 months. And I've lost like 2 or 3 pounds in that time because I was pretty fat free to begin with except in the chest. I'm really lean and I don't want to try to bulk up my chest to try fill it in too much. It's just discouraging that a great surgeon who actually did a great job on my chest can all over sudden be so loose. It was tight and flat right after surgery too. I'm afraid that maybe I'm TOO active and I may have been hurting the healing process all along. I'm willing to wait to 6+ months... I can wait any amount of time it really takes, it's just every time I ask, I'm told to wait longer. Oh, wait 3 months. Wait 4 months. Give it 5 months. Given that I'm pretty active 3 weeks after surgery for 5 straight months, is it possible I've been hurting things all this time?

[DrBermant]

Laser skin tightening does not work well. Look for actual before / after pictures and video to see if this technique really works as claimed before trying. Ask about scar issues especially on the chest and pigmented areola.
Hope this helps,

Is there anything that can actually help? I'm not gonna believe all those tv miracle creams or stuff I see on the internet. My doctor gave me the go ahead to start exercising 3 weeks postop and that's what I have been doing for the past 5 months. And I've lost like 2 or 3 pounds in that time because I was pretty fat free to begin with except in the chest. I'm really lean and I don't want to try to bulk up my chest to try fill it in too much. It's just discouraging that a great surgeon who actually did a great job on my chest can all over sudden be so loose. It was tight and flat right after surgery too. I'm afraid that maybe I'm TOO active and I may have been hurting the healing process all along. I'm willing to wait to 6+ months... I can wait any amount of time it really takes, it's just every time I ask, I'm told to wait longer. Oh, wait 3 months. Wait 4 months. Give it 5 months. Given that I'm pretty active 3 weeks after surgery for 5 straight months, is it possible I've been hurting things all this time?

No, I have not yet seen a satisfactory solution for loose skin that dynamically works well other than skin reduction techniques.

Swelling can inflate and hide loose skin. Once swelling goes down, then some may have a loose skin factor. How well skin shrinks depends on many factors. Building muscle can help with some loose skin, but then there is the issue of maintaining that muscle mass. Bodybuilders sag when they eventually lose muscle mass. Timing for Exercise and Return to Activity depends on many factors. But stress injured tissues and the healing will be slowed with continued further injury. This surgery is like recovering from a sprain. You do not heal a sprain by stressing that tissue. The exact timing varies varies depending on many factors.

Hope this helps,

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