indentations / Creasing ?

[jimboyeeehaw]

Hey Peoples

Me again... (changed username from 'yeeehaw')  4 weeks post ops and large lump/hematoma thing is pretty much all gone on the left side.
Quite abit of swelling still i guess as it feels quite hard in places.  new problem now ofcourse
On my left side there is a big creases under the nipple area where the scar is i suppose.
It feels like there is nothing supporting the area so it kind of goes indented/creased.

A week or 2 ago my right side went quite indented just when I flexed and my surgeon said to massage the scar tissue. Now its starting to get indented when I just stand relaxed. Im not sure if its because of massaging or if its helping... doesnt appear to be helping the situation though.

I know some of the docters on this site recommend not to massage for a while after surgery ? Wondered if any of the Doc's against massaging could specify why they dont advise it ?

* edit * not sure if left/right has identation/crease issue.. either or.. grrr

[jimboyeeehaw]

Anyone else get the puffy nipple thing after surgery ?
left side seems to have it. Kinda of sucks because its wierdly shaped now, and didnt have it before.
When I wear a tighter tshirt I look better then before the surgery but when I wear a looser one it actualy looks worse now Hopefully it gets better the next couple of weeks..

It just never ends

[DrBermant]

Anyone else get the puffy nipple thing after surgery ?
left side seems to have it. Kinda of sucks because its wierdly shaped now, and didnt have it before.
When I wear a tighter tshirt I look better then before the surgery but when I wear a looser one it actualy looks worse now Hopefully it gets better the next couple of weeks..

It just never ends

Puffy Nipple Complication After Gynecomastia Surgery does happen. I have seen many patients unhappy after other surgeon's work. For most it is technique related, which is why it is so critical in picking the right surgeon for this operation. Other problems like Hematoma After Gynecomastia can and do happen, it is a matter of trying to minimize such complications. My rate of needing a drain for such issues is about once every 2 to 3 years. Higher rates can also be a symptom of a technique problem. When hematoma is the issue, it can take much longer for the tissues to stabilize. Sometimes the blood does not completely dissolve leaving an internal deforming scar. In such cases, being patient is the first step.

Hope this helps,

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

[jimboyeeehaw]

Thanks for the info/links

Dont think I have hematoma issue anymore, was at Surgeon on friday and she said theres nothing left to drain. Was kind of hoping the puffyness was caused by excess blood or something, but nope.

Bit disapointing because I can aparantly wear the vest less now (been over a month) so was hoping to not have to wear it during work. Only have a couple tighter tshirts though...

Looks abit wierd, not the typical puffy nipple thing, it sort of points at an angle to the side, Feels like theres something hard behind the nipple (harder than the gland  i could feel pre-op) so hopefully whatever it is goes away.. soon...

I shall continue waiting as my Surgeon recommended =)

[Dr. Elliot Jacobs]

At this point, the best thing to do is nothing.  Let everything settle down and observe for several months.  Many times, minor creases will disappear -- but not immediately.

Dr Jacobs

[DrBermant]

Thanks for the info/links

Dont think I have hematoma issue anymore, was at Surgeon on friday and she said theres nothing left to drain. Was kind of hoping the puffyness was caused by excess blood or something, but nope.

Bit disapointing because I can aparantly wear the vest less now (been over a month) so was hoping to not have to wear it during work. Only have a couple tighter tshirts though...

Looks abit wierd, not the typical puffy nipple thing, it sort of points at an angle to the side, Feels like theres something hard behind the nipple (harder than the gland  i could feel pre-op) so hopefully whatever it is goes away.. soon...

I shall continue waiting as my Surgeon recommended =)

You are welcome.

As the collection of blood from the hematoma is dissolved this is an injury recovery process. These healing tissues can be firm and contribute to a contour problem. So the actual collection of blood my be gone, but the after effects persist. The question is will the tissue soften or have a residual deformity?  That is why I work so hard at hematoma and bruising minimization. Less swelling, less bruising, better healing potential, less gambling as to what the result will look like.

Hope this helps,

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

[jimboyeeehaw]

cool thanks again Dr's I shall be patient and see what happens. Right side indentation/creasing seems to be improving when i flex (and isnt aparant anymore when relaxed) so thats a good sign atleast.
Hopefully 'ol lefty does whatever the right side is doing

One more question, and I know I should be asking my Surgeon, I always forget to ask... (only going back in 3 weeks) I just had gland removal, but under the chest area towards armpit I have a little hole on each side.
Kind of where you see the holes with people who had Lipo, but the hole on me looks alot smaller. Would they generaly be from the needle from local anesthetic ? I had the general, but im assuming you might also add some local to the area ? There not causing any issues, was just curious about them.

[jimboyeeehaw]

hmm still no improvements on the left side in regards to the puffyness/creasing. They both appear to be related though so i guess when one improves so with the other.

Im not sure sometimes.. I think in general it looks a little bit better than before surgery. but yeah.. the puffyness/creasing isnt very appealing...
Has only been 5.5 weeks so still alot of healing to go i guess. Hoping the surgeon can do some magic trick or smething when i go back in 2 weeks.  

[DrBermant]

cool thanks again Dr's I shall be patient and see what happens. Right side indentation/creasing seems to be improving when i flex (and isnt aparant anymore when relaxed) so thats a good sign atleast.
Hopefully 'ol lefty does whatever the right side is doing

One more question, and I know I should be asking my Surgeon, I always forget to ask... (only going back in 3 weeks) I just had gland removal, but under the chest area towards armpit I have a little hole on each side.
Kind of where you see the holes with people who had Lipo, but the hole on me looks alot smaller. Would they generaly be from the needle from local anesthetic ? I had the general, but im assuming you might also add some local to the area ? There not causing any issues, was just curious about them.

hmm still no improvements on the left side in regards to the puffyness/creasing. They both appear to be related though so i guess when one improves so with the other.

Im not sure sometimes.. I think in general it looks a little bit better than before surgery. but yeah.. the puffyness/creasing isnt very appealing...
Has only been 5.5 weeks so still alot of healing to go i guess. Hoping the surgeon can do some magic trick or smething when i go back in 2 weeks.   

Tissue evolution can take quite some time. That is why I prefer techniques with a result that starts out close what I am looking for right on the operating table. Being patient can be difficult, but this is like watching a pot of water waiting for it to boil.

Michael Bermant, M.D.

[jimboyeeehaw]

Yeah I think my Surgeon uses the same technique. Quite happy with the overal shape / feeling of everything.  I was abit worried i'd still be a bit flappy without the lipo, but everything feels quite nice and firm. The puffyness is like less than 1cm so its not toooo bad. Ive got faith in my Surgeon it will all pan out nicely. She's been doing this for like 20 yrs.

Scars are healing reaaaallly well though Im quite suprised. Accidental (much more minor) cuts on my arm etc etc take longer to heal.

Thanks again for your assistance.. and putting up with my whinging
 

[aleksandar]

Hey man, hope you're doing well. We had the same surgeon, S.T, but I am only 8 days after surgery. At this stage I have very similar problems to yours - left side looks puffy, right side nipple collapsed/creased and right side visible indentation (area around the nipple depressed inwards, even more so when flexing). The indentation and the creased nipple look bad and this worries me a lot, but seems to be the result of the compression - it looks to me that the muscle was heavily compressed by the bandaging, the tapes and the vest, and it is slowly coming out, filling in. What was your experience? How long did it take for the indentation/nipple crease to come to normal? You mentioned that now it is not indented even when flexing. Was it few weeks before this happened? Please let me know. Also, is the puffiness any better now?

I made a decision not to wear the vest for few days, although I am very early after surgery. This is because on one hand I have very little swelling (except on the left side which according to the surgeon causes the puffiness) and on the other hand the vest provides further compression, which I don't think is what I need at this stage. What I need at this stage is to let the muscles have space to fill out as before the surgery. With further compression I doubt the depressed area will go away easily. It's like having a tight ring on your finger for few days - you take it out and you see the place where it was is now compressed/depressed following the shape and size of the ring, and the surrounding area of the finger may be swollen. But you need to keep the tight ring off for the area to heal. I took off the vest yesterday, after the stitches were removed, and I can say with a certainty that already today, after only one night the right side looks a little bit better. Another good sign is that the left side was depressed as well in the early days immediately after the surgery, but no longer is, so I assume the right side will catch up - the way i see it it's only compressed muscle. As for the nipple I am just hoping it will start assuming normal shape. It all looks scary now - puffiness, indentation, creasing - but I am only 8 days after surgery so I am optimistic things will radically change in the next days/weeks...I know many people with our surgeon on this board report things look great the day when the stitches come off, but we are not all that lucky. Patience is the key now I think...

[jimboyeeehaw]

my situation was a lil differant, for the first 3 or so weeks my left side as pretty big (not puffy but the hole thing was big... when i walked i could feel the hole breast jiggling around) due to excess blood.
Once Sue drained it (only needed it drained once) it went down quite abit, then it was just the puffyness/creasing.

Right side looked perfect from day-1 preop. Only had the indentation when i flexed.

Now im just over 6 weeks post op and  right side still has indentation when flexed but it seems to be improving. Sue told me at around this stage (6 weeks) the scar tissue will soften which is causing the indentation when i flex.

Left side is still puffy (but like maybe 3mm which isnt much at all) but appears to be improving and the creasing is also definetly improving.

Im no docter... so take this advice with caution... but i strongly believe you need to wear the compression vest as long as possible. 24hrs a day for the first 4 weeks. I was actualy wearing extra cotton pads to increase the compression on my left side (Sue's advice). After 4 weeks Sue told me i can wear it less but to still wear it. At 4 weeks the puffyness (without the vest) made me look abit wierd and self conscious with a loose tshirt on so was still wearing the vest during the day at work, then took it off at home for a few hours, then back on when i sleep. I was still pretty upset after 4 weeks.

After 5 weeks things improved and now I can wear loose tshirts and things look great. Now at 6 weeks im just wearing the vest before i goto bed then take it off in the morning before work.
Im going for another checkup in a week with Sue, and I shall still continue to wear the vest. Might even keep wearing the vest even if she tells me I dont need to - unless she advises it will now cause a negative reaction..

As I said I still have minor puffyness and creasing (but improving) but I feel abit stupid for doubting Sue and getting worried. basicaly everything she said would happen in regards to improvements has happened. Still abit of improving to happen till im 100% happy but im positive it will all come good. My self confidence in regards to chest has very much improved now (in the space of a week or 2!) and very very happy i had the surgery.

Again in no docter... but it looks like alot of people stop wearing the vest at exactly 1 month and there puffyness doesnt improve, so i rekon the vest has alot to do with healing. But yeah, follow Sue's advice 100% and dont take the vest off (unless she tells you to).

I wont mention names but I've also been chatting to another fellow on this forum who had his surgery with Sue literaly 2 hours after mine and he's also been wearing the vest for longer than 4 weeks and also believes its helping.

Your only 8 days, so I realy wouldnt worry (allthough i did for first 5 weeks hehe) If you do have problems Sue will fix them up for ya im sure. Shes been doing this for 20 years and is a top class surgeon. Shes the australian version of the 2 expert surgeons on this forum

Best of luck

BTW.... howd it feel getting the drainage tubes pulled out ?

p.s - put the vest back on and follow yours surgeons advice 1000000000%. You paid alot of money for the surgery, so you owe it to yourself to follow the docters orders and gain the benefits of there post op expertise.

[aleksandar]

Ok mate, thanks for that. I'm putting the vest back on. I was too worried that I may be suffering from the dreaded "crater" effect on the right side, but since I can definitely see the muscle filling in slowly I doubt that's the case. She couldn't have possibly cut muscle tissue with her experience. Plus, I doubt Sue would leave me with a crater after operating 20 years in this area. Yeah, the left side looks very puffy and I think the vest will help the healing process. I'm quite convinced the puffiness is scar tissue/swelling, and not breast tissue. As for the vest, I know some good surgeons who do not advise wearing vest at all, it's just compression bandages after surgery for a week or so. On the right side I really think any further compression is not needed, moreover it can be detrimental, but I cannot only wear the vest on one side... It's a tough decision, but I think you're right - it's best to follow Sue's advice to the letter and pray for the best. It's still too early for me to be doing all this whinging. I'm positive it'll all look more than great in few weeks...

As for the tubes coming out - it was the worst pain I've felt in my whole life. And it's not like I've never been in pain before. I'm lucky I didn't loose conscience.

Good luck and please keep your thread alive...do not disappear from the boards and let me know how things are developing. A picture when you feel confident enough will be great as well...

[jimboyeeehaw]

hehe totaly agree with the drain removal = worst pain EVER.
only thing which made it worth while was the hot young blonde nurse rubbing my stomach after she saw the pain i was in =)

Im abit disappointed because when I changed my username ALL my threads/posted got deleted for some strange reason.

Will try get some pics up next time im at my parents house - self portrait shots with phone are somewhat useless.

If you need someone to whinge to, feel free to PM me.. I did ALOT of whinging but yeah as everyone will tell ya, just need to be patient. I know post-op can be a VERY stresful month or 2.

[Squish33]

Hey fellow Aus guys!
I'm just 7days post op now and starting to get slight creases as well  (above incision, below nipple) maybe about 8mm long? Could get worse only started yesterday.
I am average build and am VERY worried about going from not being able to take my shirt off because of the gyno to because of these splits across my nipples. I have no puffiness (slight swelling/ bruising) and all else looks fairly run off the mill.

I am starting to become itchy now and am continuing to wear the vest for a month although it feels slightly loosish around the top especially when I sit.
And yes the drains hurt... very uncomfortable but not worst pain I've felt hahahah.

So - I am EXTREMELY curious as to how your creases are healing? are they going away?

oh also - it's irrelevant now, but my op was $9700 :/ because I live in a fairly rural area and my PS does a lot of traveling that's why I'm guessing the increased cost. How much did it cost for you?
Thanks and I'd like to stay in touch