6 months post-op 2 surgeries

[California31]

Hello doctors,

First time posting after looking through numerous posts.


I was in the Army stationed in Georgia, first had gyno surgery by a gs in April 2016.  I had lots of fluid built up and I was patient as many advised, but this caused fluid capsules with mature scar tissue solidified around them that required a 2nd surgery.

This revision surgery was performed by an actual plastic surgeon on October 11, 2016.  The results were excellent and had a completely flat chest for 2-3 months.  Things seem to only be getting worse now though.  I know that if the chest was flat after surgery then chances are its scar tissue and it will return back at some point but this seems odd at 6 months post-op. 

I tried to schedule an appointment for kenalog injections with a ps here in Southern California, but they wont do them because they did not perform the surgery.  They recommended trying a dermatologist. 


Link below has pictures from 1 month po at the bottom and present time up top



http://imgur.com/a/5PG3e



Thoughts?  Thanks!

[Dr. Schuster]

I don't understand what the problems are that you are concerned about.

[California31]

My concern is the difference between 2/3 months and 6 months post-op seem to be substantial in the negative direction and if it is normal.


If kenalog injections are the answer and if a dermatologist would be a good alternative to a ps for them.

[California31]

Went and got some Kenalog injections today by a local highly rated Dermatologist.

He said he isn't the expert and doesn't know for sure, but said he thinks there still maybe some remaining breast tissue.  Im skeptical on that because my chest was indeed flat and near perfect for the first 2-3 months.


However, there is definitely a difference because they are puffy and "cone-like" now.  They aren't bad as before the surgery, but definitely worse.  Is there any chance at all that I'm just more prone to gland growth?

[Litlriki]

From the appearance and from your story, I think it's likely that what you're seeing is related to scar tissue and that Kenalog could give you improvement.  That said, unless you see a plastic surgeon who deals with gynecomastia frequently, you'll find resistance to doing the injection. It's not a big deal, but most practitioners prefer to treat their own patients for this sort of problem.  Those of us who do a lot of this surgery and inject the scar tissue with some frequency are comfortable with injecting other surgeons' patients, since the anatomy and the procedure is pretty much the same, even if a surgeon uses a slightly different technique.  Dermatologists aren't surgeons, but many treat scars.  Because the scar tissue in gynecomastia is deeper and not the incisional scar itself (most of the time), they may not feel comfortable doing it either.  

[California31]

Thank you for the response, I appreciate it. 


I fully understand any doctor not feeling comfortable with doing the injections. 

At the moment there seems to be swelling and/or possibly the kenalog fluid built up where it was injected which I suspect either are fairly normal as it hasnt even been 12 hours since the time of injection.

I am hopeful to see some progress within the next few days, but I am aware it may take up to 6 weeks (and possibly more injections) for the full effect.  As long as it solves the issue thats all that matters to me as I REALLY would like to avoid a 3rd surgery.

[Dr. Schuster]

I agree with Dr. Silverman

[DrPensler]

When I review photos of an area the photos need to be comparable. The patient must be in the same position with comparable lighting with the same degree of muscle flexion ,the same size and cropping of the anatomy. why don't you post a photo that is similar to the early post-op photo.

[California31]

Thank you for the replies.

Here are some similar images from early post-op (first week then approx 1.5 month post-op)


http://imgur.com/a/PU1aT