Tethering

[tim5726]

6 weeks post op
In one pic I'm flexing
Other pic is at rest
Two questions:
How frequently is tethering at 6 weeks resolved by just massage?
Is tethering at early stages (6 weeks) common or is it considered a possible complication?
Thank you very much.

[DrPensler]

I consider anything that is not close to perfect a potential complication. You should be clear to distinguish a potential complication from an actual complication that requires surgery. having said that I can see what you are talking about. I am not sure where you started or what was done so its a bit difficult to assess you completely. Regardless of the exact nature of your situation I can say at this point you need to sit tight and see what develops.I think massage in situations like your has no down side and can help significantly in some instances.
I do not think its a good idea in general to self treat at this point in your recovery so I would suggest you contact your surgeon and get their input.You can also consider a second opinion from an experienced surgeon who specializes in gynecomastia.

[tim5726]

Thank you Dr. Pensler.
It was a basic gland removal and lipo done under local anesthetic as it was a relatively minor case. I have a very experienced surgeon that I trust but it is important for me to seek other opinions on here for reassurance. I have contacted my surgeon as well and am awaiting their response.
Is this what tethering looks like when too much gland has been removed below the nipple? 

[tim5726]

more pics when arms are raised and stretched as hard as possible. normal raising doesn't show the unevenness as much.
Although its still too early to be definitive, is the possibility of a revision becoming more and more likely?
fyi areas are red just after massage. 
Thanks

[Dr. Schuster]

I agree with Dr. Pensler as far as still be fairly early in the recovery. I would recommend vigorous deep massage to break up anything that feels tight, but you should run this by your surgeon before doing anything.

[Dr. Elliot Jacobs]

Even though it is relatively early in your post op healing, it does appear that you have a crater on the left side.  No amount of massage will un-do this.

Oftentimes, surgeons will look at a puffy nipple and think that it can be done easily and quickly under local anesthesia.  After having done thousands of these procedures, I can tell you that I spend virtually the same amount of time doing a small puffy nipple case as a large case.  They are tricky operations and should not be regarded lightly by the patient or the surgeon.

I would strongly suggest you seek a second opinion, preferably from an experienced gyne surgeon.

Dr Jacobs

[Dr. Schuster]

While I generally agree with Dr. Jacobs, I do not think revision is a good idea at six weeks. At this time the scar tissue is the worst to deal with and least predictable (in my opinion). Although you could certainly discuss with your surgeon my guess is that you should wait at least 3-6 months before going back. I also think that there is still room for improvement with massage at this time. Judicious use of kenalog might also help very tight areas but must be extremely careful.

[Dr. Elliot Jacobs]

Agree with Dr Schuster.  Revision surgery should not be contemplated until at least six months after the initial surgery.  During that healing time, you should take the opportunity to speak with your surgeon about the results and also consider a second opinion.

Dr Jacobs