Concerned in Dubai. Please help.

[ivoi3]

Hi Doctors,
I had Gynecomastia surgery on the 14th of April, 2016. It was a glandular excision and ultrasound assisted liposuction. I had drains put in for 3 days after surgery.
The right side of my chest has been healing wonderfully. Almost zero bruising or swelling. However, the left side of my chest has been pretty swollen and bruised. The bruising has gone down but it's still significantly swollen. I'm a little worried since one side is healing a lot quicker than the other.
The PS did mention that the left side of my chest required a little more work because of the "fibrous tissue".  I am also left side dominant - almost everything I do is with my left hand or foot. I don't know if that makes a difference.
Any help or advice would be appreciated. I can post up some pictures if it will help.
Thanks.

[Dr. Elliot Jacobs]

Please post some photos -- front, side and 3/4 views to illustrate your concerns.

Dr Jacobs

[ivoi3]

Hi Dr. Jacobs,
Here are some pictures. Thank you so much. My PS is actually away until Friday. I've booked an appointment to go see him. In the mean time, I hope you can help me out. I'm worried if this is a hematoma and if left untreated could cause complications. 
Thank you and God bless you. 

http://i.imgur.com/rZ57WDy.jpg
http://i.imgur.com/FNMuFvI.jpg
http://i.imgur.com/JADfyxn.jpg

[Dr. Elliot Jacobs]

I am afraid that more likely than not, this is a hematoma -- and a rather large one.

Make sure you see your surgeon ASAP.

Dr Jacobs 

[ivoi3]

Thank you for the reply, Dr.
What do you think is going to happen? Is this serious? Will it affect the results? Sorry, it's 2 AM here and this is my only resource at the moment.

[Dr. Elliot Jacobs]

Honestly, you are not my patient and I cannot tell you what should be done.

However, in general, hematomas which are large can produce healing problems because some of the blood is turned into scar tissue.  

It is my opinion that large hematomas should be surgically opened (through the peri-areolar incision) ad the clotted blood removed.  The healing then progresses well.  Other surgeons, however, may disagree with me and just choose to watch and wait.  that is why you should see your surgeon ASAP.

Dr Jacobs

[Litlriki]

I would agree with Dr. Jacobs, and hopefully by now, you've addressed this.  In some cases, serial aspiration of the hematoma is possible, but in some cases, opening and evacuating the hematoma will aid in a quicker resolution of the problem.  

[ivoi3]

Hi Doctors,
Thank you both for your replies. This website really is a saving grace. Just a quick little update, it turns out it was just a really large seroma - the pictures make it look a lot worse than what it is. My PS didn't seem too concerned and has since drained it twice. It looks a lot better but I think it needs a few more drains because I feel some liquid sloshing around. It's really frustrating since the right side is healing so well! I hope this seroma clears up soon and isn't permanent.

[DrPensler]

With drainage depending on what was done etc. there is a 50% chance there will need to be an additional drainage/aspiration.

[Dr. Schuster]

You should continue to have it drained until no more comes out. At some point gentle massage to break down scar tissue would be a good idea. But first check with your surgeon.

[ivoi3]

Hi again Doctors,
Thank you all for your responses. I've said it before and I'll say it again, you guys are a heaven sent.
I've since had the hematoma/seroma drained three times and this is how I'm looking exactly 1 month post op. 

https://imgur.com/Qp3voxF
Theres still some swelling and a little fluid but the doctor said that the rest should he absorbed by the body. Will it continue to improve?

[Dr. Elliot Jacobs]

It looks much, much better and should continue to improve.  Ultimately, it should be close to symmetric with the other side (if it isn't already).

Glad we could help you out!

Dr Jacobs

[ivoi3]

Hmm, I'm not sure what happened to my previous question and answer by Dr. Elliot.
I believe the site was a little glitchy over the last few days.

Things seem to be progessing okay - there's still some soreness and scar tissue but I think that will get better over time. I was wondering - is it okay to rub Voltaren Gel (Dicoflenic Sodium) on the sore spots on my chest?

[Dr. Schuster]

You should ask your own surgeon.

[ivoi3]

Thanks Doctor.
I'm starting to become extremely frustrated with my surgeon - I wait for weeks for a follow up appointment and he spends less than a few minutes addressing my concerns. I don't understand this. The left side of my breast still feels swollen and tight whenever I raise my arms over my head. There is a significant amount of scar tissue underneath the nipple. I use a massage roller and you can literally feel the roller go over a lump of scar tissue; it's a like a speed bump.
He brushes off my concerns and tells me to wait for it to soften and doesn't entertain the idea of a kenalog shot. It seems like the more questions I asked, the more frustrated he became and mentioned that I was over-reacting and the results are very good. I'm a pretty level headed person and I think my concerns are legitimate. The results are good, I didn't say they weren't - but the scar tissue is becoming extremely frustrating. I tried to do a few push ups the other day and there's still a significant amount of soreness.
I may consider finding another surgeon to address the scar tissue.
I'm sorry for the rant - I just wish that surgeons understood that while they do hundreds of these surgeries a year and they've seen it all - we only do it once (hopefully) and we may have concerns.