Scar tissue

[tgv1337]

Hello,
I'm 33 years old and I come from Germany. I had 2 gynecomastia surgeries in the past, initially I had only puffy nipples, bilateral (Typ 1 gyne). With 20 years I've undergone a surgery (liposuction plus removal of the glands). After this surgery there was still some gland under the left areola, so I had a revision on the left side (no liposuction this time). After the surgery the areola was completely flat, but after a few weeks the nipple has become slightly puffy again and it's puffy since then. I assume it's my fault, since I didn't wear the compression vest regularly. I am very lean and muscular with sixpack and so on, but there is still a difference between the right (good, completely flat) side and the left, slightly puffy side areola.

My questions are:
1) If the reason for the puffiness of the areola is scar tissue, is it possible to fix it with cortisone injections, considering the revison surgery was 10 years ago?
2) If not, would I have to wear a compression vest again after the surgical removal of scar tissue?
3) Is surgical removal of scar tissue as tricky as removal of gland tissue and therefore the risk of crater-buildup as high?
4) After surgical removal of scar tissue, would I have to wait 4-6 weeks before I start again going to gym?

Thank you in advance for your answers,
tgv1337

[Dr. Elliot Jacobs]

Your story sounds as if there could be some scar tissue build-up under the left nipple -- but one cannot be 100% sure since you do not know precisely how much tissue under the nipple that the surgeon retained.

Assuming it is scar tissue, then the best treatment would be cortisone injections -- they work!  Surgery to remove scar tissue will just result in further scar tissue.  However, if the problem is retained gland/breast tissue, then cortisone is not the answer and only an additional surgical procedure can help to flatten the nipple.

Best to consult with your surgeon to discuss exactly how much, if any tissue, he retained under the nipple.  Then go from there.

Good luck!

Dr Jacobs

[tgv1337]

Thank you very much for your answer Dr. Jacobs.

[Dr. Schuster]

Hopefully it's jut a little scar tissue. A carefully performed kenalog injection will help scar tissue but not residual gland. Check in with your surgeon.

[Litlriki]

I would agree with the other surgeons regarding potential for scar tissue based on your description.  If you have another procedure, depending on the recommendations of your surgeon, workouts can start before 6 weeks.  I allow patients to start cardio after a week and resistance at 2 weeks. In any case, you should consult with your surgeon. 

Rick Silverman