post-op question

[freeatlast?]

hey guys

im 21 and ive had puffy nipples with glandular tissue behind since i was 12. i had the surgery done last monday. i have a couple concerns....the left side nipple became flat and exactly what i was hoping for, however the left side of my chest swelled up to bigger than it was pre-op. my chest was also hard and tight unlike the right side which was normal. i went back to my ps for the follow-up visit this past tuesday and he said there was "old blood" in there and he would have to re-open the incision and take it out. he said it was the consistency of grape jelly, which i know is pretty gross, but whatever. so he took it all out, stitched me up again and the left side of my chest looked great. however, later that night, my chest swelled up again and it was the same story. very hard and tight just like before. i shot over to the ps office and he said we would have to do another procedure except this time, he would have to put me under for it (the first two were done with local anesthesia) so he could attack it more aggressively without putting me through a lot of pain. that procedure is scheduled for tomorrow. i was wondering if anyone ever experienced something like this and how it was resolved.

also...

the right side is painless, it's almost completely bruiseless however the nipple is still protruding. not flat at all. my chest is definitely flatter, not as flat as i would like, but i could live with it if the nipple was flat. it is not and the ps says i will like the result when the swelling goes down in about a month or two. i dont see how this is possible. could the nipple become flatter as the swelling decreases? only the chest appearance is what swelled right? this doesnt seem right to me. anyway i was also wondering if anyone had any experiences with this...a puffy nipple pre-op, a semi-puffy nipple post-op, and then had the puffy nipple flatten out over time with the decrease in swelling.


thanks for reading guys and i appreciate any comments/replies.

[reaper33]

 it sounds like you gotta fluid build up, which is usually drained by making incisions under the armpit, never heard any surgeon had to open up the incisions for that. pretty new to me, who was your surgeon and what procedure did you get? as far as the other side, swelling should go down with time assuming you had excision as well, coz i have puffy nips aswell and lipo only wont work and you gotta get the gland excised, if you did get the gland out, then i dont get why you still have the nips protruding, anyways hopes up, you ll be fine.

[DrBermant]

hey guys

im 21 and ive had puffy nipples with glandular tissue behind since i was 12. i had the surgery done last monday. i have a couple concerns....the left side nipple became flat and exactly what i was hoping for, however the left side of my chest swelled up to bigger than it was pre-op. my chest was also hard and tight unlike the right side which was normal. i went back to my ps for the follow-up visit this past tuesday and he said there was "old blood" in there and he would have to re-open the incision and take it out. he said it was the consistency of grape jelly, which i know is pretty gross, but whatever. so he took it all out, stitched me up again and the left side of my chest looked great. however, later that night, my chest swelled up again and it was the same story. very hard and tight just like before. i shot over to the ps office and he said we would have to do another procedure except this time, he would have to put me under for it (the first two were done with local anesthesia) so he could attack it more aggressively without putting me through a lot of pain. that procedure is scheduled for tomorrow. i was wondering if anyone ever experienced something like this and how it was resolved.

also...

the right side is painless, it's almost completely bruiseless however the nipple is still protruding. not flat at all. my chest is definitely flatter, not as flat as i would like, but i could live with it if the nipple was flat. it is not and the ps says i will like the result when the swelling goes down in about a month or two. i dont see how this is possible. could the nipple become flatter as the swelling decreases? only the chest appearance is what swelled right? this doesnt seem right to me. anyway i was also wondering if anyone had any experiences with this...a puffy nipple pre-op, a semi-puffy nipple post-op, and then had the puffy nipple flatten out over time with the decrease in swelling.


thanks for reading guys and i appreciate any comments/replies.

A hematoma after gynecomastia surgery is a collection of blood.  Timing for drainage depends on many factors.  Waiting until the blood softens is sometimes the correct treatment.


How tissues evolve after surgery depends on the problem treated, surgical technique, skill of the surgeon, after care, scar care, and how a patient heals.  I prefer my Dynamic Technique in which there is minimal bruising and swelling.  The biggest change happens on the operating table.  That is how I am able to post images the day after surgery.  However, further refinement happens over time as sculpted tissues evolves as they soften with scar care, compression, and healing.  As with any cut, tissues need to heal and soften.

You can see other examples of early resuts:

in this competition body builder here.

This one sided (unilateral) gynecomastia shows the swelling after surgery typical swelling after my gynecomastia surgery compaired to the side that had No Surgery. 

Here is another example of early healing after unilateral surgery typically seen with my techniques. 

Here is another example of typical minimal swelling and bruising in a 14 year old patient with more images images of tissue evolution and swelling here.. 

You can find many more examples on my website of primary gynecomastia tissue evoluation.

I perform many Revision Gynecomastia Male Chest Sculpture Operations on patients done by other doctors around the world. Each patient has told me how different their tissues were after my Dynamic Technique compaired to their previous surgery.  They all have commented how the swelling was much less, comfort better, and their expectation met, even at their first view of the tissues after surgery.  You can see typical tissue evolution after Revision Gynecomastia Surgery here.

However, even with these techniques, the tissue continue to evolve over time.  Here is another example of a patient revised after initial surgery done in Australia, early and 2 years after his operation.

This is real surgery and tissues do need to heal just like any other cut or injury.

Scars after surgery depend on the problem to be treated, surgical technique(s), complications, skill of your surgeon, after care, scar care, how you heal, and other factors.

The areola chest skin interface is a great place to hide a scar.  Check out the many before after pictures of this Areola / Nipple Gallery here, here, and here.  These results are typical for my sculpture of my patients.

How tissues move is important.  The human body is beautiful in animation.  That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views.  Limited view demonstrations can pick the best angle to hide deformities and problems.  Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor.  It is like an artist selecting a paint brush.  The results are what matters, not with what tool they sculpt.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture