Indentation after Gyno Surgery...

[zshane1125]

Hi experts and docs,

I had gyno surgery a week ago, gland removal and lipo on the right pec and lipo only on the left, but I notice an indentation on my right pec. Is this a serious procedural problem or is it just some normal post op irregularity that will go away on it's own?

I told my concerned to my surgeon and a plastic surgeon consultant, they told me that it's normal and it's just extra swelling since more was done on the right pec vs left pec, it will eventually even out in a few months. Massage and extra compression might help.

But I think it does not look like extra swell, it looks like the muscle is caved in, or they accidentally made a cut, or too much tissue was removed. I know it's too early to tell, but it just looks very deformed, and when I wear a shirt, it looks like my right pec is divided into three pieces.

All opinions welcome, thanks.

[Geoff88]

It is likely to be too early to assume how the final result will look, others more experienced can provide feedback.

My advice is to keep compression up for at least 10weeks, longer than generally advised.  If you feel hard spots or scar tissue developing then reapply bandages or extra compression to reduce them.

The one thing that does not seem to be well understood is scar tissue development and my experience is that reapplying extra compression (bandages or a tight chest bind) helps eliminate them rather than disturbing healing tissues with a massage.  I wouldn't massage or over-touch the areas, you need months before seeing the result.  I'm 15 weeks post op and things are still changing, contracting, healing.

[zshane1125]

I am so depressed because of this, I can't imagine seeing my chest split in half everyday wearing a shirt, and the indentation after taking the shirt off.

Wtf seems to be the problem? is it indentation because extra tissue was taken off, or is it scar tissue, I don't understand.

My confidence has been completely shot.

[SmokeyNYY]

Way too early. I had something similar (not as bad) but it completely went away. Give it some time. Take daily pictures to see if any difference is happening. Then re assess in a few months.

[Geoff88]

Wtf seems to be the problem? is it indentation because extra tissue was taken off, or is it scar tissue, I don't understand.

No it definitely isn't scar tissue, you would not develop such scars in just a week or two.  It would not be a cut to muscle either.  It would most likely be swelling precisely as your doc has mentioned.

You'll need to be patient, I'm certain you would have been advised that results take a while to exhibit themselves, and 99% of the posts on this forum reiterate the same same thing over and over.  You will have swelling for a while, and the "final" result will take months - you seemore representative differences after 8 weeks not 8 days!

Just adhere to your doctors guidelines and apply ample pressure to the surgery site, and leave your chest alone (don't feel it all the time or massage it at this stage - it needs to heal).  If hard lumps appear, reapply lots more pressure and don't massage until much much later.

As for appearance, you're simply going to need to wait, you'll be fine.

[zshane1125]

Wtf seems to be the problem? is it indentation because extra tissue was taken off, or is it scar tissue, I don't understand.

No it definitely isn't scar tissue, you would not develop such scars in just a week or two.  It would not be a cut to muscle either.  It would most likely be swelling precisely as your doc has mentioned.

You'll need to be patient, I'm certain you would have been advised that results take a while to exhibit themselves, and 99% of the posts on this forum reiterate the same same thing over and over.  You will have swelling for a while, and the "final" result will take months - you seemore representative differences after 8 weeks not 8 days!

Just adhere to your doctors guidelines and apply ample pressure to the surgery site, and leave your chest alone (don't feel it all the time or massage it at this stage - it needs to heal).  If hard lumps appear, reapply lots more pressure and don't massage until much much later.

As for appearance, you're simply going to need to wait, you'll be fine.

Thanks, but I am so worried. I did alot of research on post op indentations, and all these guys were told to wait few months, but you never hear from them again. Some came back after a few months looking the same and it's even worse. 

In my case, it looks like a crater deformity almost, a depression that's causing the major contour problem....

[Dr. Elliot Jacobs]

It is only a week after surgery.  Undoubtedly you will be swollen -- and swelling can vary on both sides, particularly if different procedures were done.

Best thing to do is to wear a compression garment and follow your surgeons instructions. There is absolutely nothing to be done at this point.  If you worry over it, it will not improve the situation and it will only give you some grey hair.

Dr Jacobs

[flatness13]

I really don't want to put more of a downer on you but worst case scenario it is muscle damage on top of too much gland/fat removal. I have the same issue as you on the same side.

What will let you know better is(and please don't do this yet since you're too early into recovery) if you raise your arms and then flex to see if the muscle attached to the shoulder still runs all the way down to the lower chest. If there is a big step-off like I have it has to be muscle damage.

Of course I hope that it's just swelling for you but I just think of my own(bad) experiences and this usually spells bad news.

[zshane1125]

I did raise my arm and flexed, the muscle runs all the way down and it seems to be smooth. I know it's too early to judge, but does something this dramatic can actually go away? It's just hard to imagine.

[Geoff88]

That's a good indication.  Yes things change substantially, I assume you have had lipo, results and swelling change *substantially*, sure there would have been guys that had permanent damage due to complication, and probably five times that number that recovered as normal - most in that boat don't return with the good news, issue solved!

You appear to be very swollen toward the lower area, so stop raising your arms, flexing etc and let yourself heal.  Follow you surgeons advice and those of the Dr Jacobs above, you simply need to heal, otherwise you'll risk possibility of self-fulfilling a negative result by interrupting that process.  Stay positive.

[zshane1125]

Ok, I will be patient....
But lets say worse case scenario, after couple months, it doesn get any better or the indent becomes worse, is it a easy problem to fix assuming too much tissue was taken out or there is a muscle cut?

[res.Cogitans]

Well, if more tissue has been taken, there is a way that experienced plastic surgeon will do with great result- they take fat from other part and put it where the crease is.
About muscle damage i dont know, but i suppose it will fix by itself in time- body has ways to heal itself even when logic cant understand..

People dont come back, because their problem is solved (or few in the worss scenario, they accept it, or just go for a revision).
A good compression (in my case simple vest didnt do the best result, so i had to do some modification for more compression in the area) is what you need, so the swelling will be less, and you will develop less (or none) hard tissue that seems so hard and feels like it will be there forever (im in that stage- 5+ weeks post op). But as all doctors say, patience and compression (i see really a difference and although its so uncomfortable to wear it 24/7 is a must).
Dont think the worst scenario , just be patient and do a GOOD compression. Is the best you can do.
Also, take photos once a week, at the same background, front, side, 3/4 side, and compare the first week with the 5th, or 10th and believe me you will see difference (a lot as time passes) .

[Geoff88]

I'd second the importance or good compression - here's a post of mine on that, keep quite firm compression up particularly on your swollen areas toward the lower half of your chest to assist healing.

Stop playing with your chest or raising your arms.  Give it more than 4 months in total, trust me things stay positive and do your best to heal right now.

Post:
https://www.gynecomastia.org/smf/index.php?topic=32360.0

[zshane1125]

Ok, I took a shower today, and here is what I observed. The skin of the indented "crease" area felt extremely tight, and there seems to be no fat whatsoever underneath, unlike the left side, which has a bit of cushion. At this point, I am pretty sure that the doc removed too much fat / tissue in the indented area, causing the skin to be almost attached to the muscle. 

As time goes by, the extra swelling from around the nipple, and near the armpit will eventually go down and bulge less. Unless the surrounding fat somehow magically get redistributed evenly throughout the indented area, I don't see how it will go away.
Just to have to live with it for 3 months I guess, then I will look for an experienced gyno revision doc to fix this problem once and for all.

[res.Cogitans]

Give yourself, more time to heal. Even if you need in the end a revision, its wise to wait at least 6 months (and not 4 as you said).
This indentation will minimize after the swollen areas (up, down and around) will go (after at least 3 months!). 
I have see many creases as yours that in time minimize at least 80% or eventually settle down and look 100% normal.
I know how you feel, and your mind is all day to that thing, but i will repeat, do good compression 24/7 and wait.. Keep us updated every 3 weeks with new photos and how it goes.. Im sure you will see differences as time passes, even than now its hard to understand it.