Expert Advice Needed - Seroma and Swelling

[digitalgod]

Surgery #1: I had gynecomastia surgery a couple years ago. This surgery took care of 85% of my problem, but after some months I noticed an asymmetric on one side. Surgeon would not do a revision.

Surgery #2: A couple years after the first surgery, I had a revision with another surgeon. Through no fault of the surgeon (who is a great guy), the result was a disaster: surgeon did not use drains because procedure was very minor, and I had persistent seroma for several months. I needed to be drained a couple times a week. A couple months after, the results were not good at all, and he said he needed to do a revision. I'm very grateful that he offered to do this for free!

Surgery #3: This surgery happened 2-3 months after surgery #2. During this revision, surgeon told me that massive amounts of scar tissue had developed after the second surgery. Things looked flat after the surgery, we put in drains and left them in for 4 (4!!) weeks.

The result of this surgery was also not good. I'm now 7 week post-op, and there is a huge amount of swelling on my left side and some on the right .I know there is some scar tissue developing as well, as I can feel it. I have been wearing a compression vest the whole time. And just now, in the 7th week, has the seroma buildup pretty much terminated. I've had to be drained a couple times a week up until now.

Basically, significant swelling is still there to the point where I can't even wear a t-shirt without it being visible. And the swelling persists even when the seroma is drained.

So is 7-8 weeks still too early? Do you think the swelling will subside in some *months*? I should continue the compression and avoid exercise? Do any surgeons have experience with this recurring seroma and its impact on surgery results?

My surgeon has also offered me another 4th surgery (free), in the coming months. I'm kinda demoralized though. It seems every surgery, I have this huge persistent seroma that takes over my life for months, even when I leave in drains for weeks. And, the swelling, scar tissue, etc...

[Dr. Elliot Jacobs]

Your story is most unusual -- I have not seen persistent seromas such as you describe.

More to the point, 7 weeks is just to early to determine anything.  Given the fact that you have had 3 operations already, it might be best to lay back and give it at least 6-8 months to heal before considering anything.  And then, if there is still minor asymmetry between the two sides, you might just consider leaving it alone rather than risking another procedure.  There are times when it is wiser to accept something less than perfect.

Dr Jacobs