Please someone reply that had post op puffy nipple

[n0thingsp3cial]

I am freaking out here, 5 weeks post-op, if I don't wear my compression vest my nipples will pop out and turn very hard, like puffy nipples but hard puffy nipples.  I wear the vest and it goes down.  Actually this is only on my right side, my left side is just puffy, not so much hard.  But when the vest goes on, in a few hours they are both flat as can be and perfect just like the first day post-op.  I have posted about this numerous times but none seems to want to help.  So this will be my last post about this.  But seriously, I am desperate, can someone with a similar post-op experience please explain whats happening?!  Am I destined to be stuck with this fucking disease?!

[Raymuk]

I got gyno from taking propecia - though my nipples themselves were never really puffy before the op, they suddenly turned acorn-like after the op, done by Paul Levick in the UK. The thing is, as far as my actual chest goes, I couldn't have hoped for a better result - it has a perfect shape now and all excess fat has gone. (I had 500cc's (left) and 600 cc's (right) taken out. Mostly fat, with a bit of gland).

After the op though, my nipples definitely stuck out and they felt rock-hard all the time It wasn't too much of a problem though as you wouldn't have been able to tell with a t-shirt on, unless it was a very tight one, which I don't wear.

About 3 weeks after the op (just after I decided I didn't need the compression vest anymore), I went out clubbing and took a girl back home with me - we were fooling around and she had her hands all over my torso when she exclaimed "Wow! - I can't believe how ERECT your nipples are!!" Funny thing was, she meant it in a good way - even though I was like "Yeah, whatever", she loved it - probably thought she had turned me on so much(?) !! LOL! Needless to say, i didn't tell her the real reason........

I'm now nearly one year post-op and I have to say that they have only improved slightly since then - i.e. they are no longer what you would call permanently erect like they seemed to be for the first month. Overall, I'm very happy with my results and I've been seen barechested many times since and no-one has ever made any kind of comments at all - my chest looks fine now and though my nips are slightly more 'prominent' than they were, nobody else has seemed to notice this at all.

[strahan222]

Hi, I'm 4 weeks post-op now and my situation is very similar to yours. If I wear the vest for a while and then I take it off both nipples look great fore like 30 minutes and then my right nipple starts poping back out. My left side is always perfect but for some reason my right side pops out after a short while when I take off the vest. And like you I was perfect the first few days post-op. I have this hard tissue kind of feeling under my right nipple. It's been this way since I stopped wearing my vest two weeks post-op. But seeing how my right nipple was I put it back on and now I wear it during the night. I'm also worried that this might not go away and that I underwent surgery for nothing. From what I've read on this forum this is happening to a lot of people. But I have yet to read an explanation about hard tissues and scar tissues and that stuff and how long it normally takes to go away. If any doctor had some explanations as to why this is happening and what should be done and not done it would be really appreciated.

[Dr. Elliot Jacobs]

There are three parties to any surgery:  the patient, the surgeon and Mother Nature.  Assuming the patient complied with all the post op instructions and assuming the surgeon did his job, then Mother Nature assumes some of the blame for a less that perfect result.

Early (within 1-2 months) after surgery. there may be some swelling under the nipples.  That is why it may improve with pressure (which "squeezes out" the swelling). 

Later on, I have found that sometimes there is a buildup of scar tissue under the nipples -- I can hypothesize about the cause but there is no absolute proof.  Bottom line is that scar tissue can develop beneath the nipple -- and the best treatment (at least in my hands) has been one or more injections of kenalog.

Dr Jacobs  

[strahan222]

Thanks for the reply doctor.

So from what I understand this is not an irremediable problem and if it persists after 2-3 months when most swelling has vanished, it could potentially be fixed with kenalog injections.

[Dr. Elliot Jacobs]

In my general opinion, that is correct.  Obviously, everyone is an individual and it would be best for you to return to your surgeon for his evaluation.

Dr Jacobs

[freeprisoner]

I have the exact problem, I am 1 month post op left nipple is always flat and looking great, but my right nipple is still puffy even more than before. Its depressing because I had to travel to another country to undergo this surgery, I always wanted to wear a tshirt without having my nipples pop out.

[gynobeast]

3 weeks 4 days and i still got fluffy nips too,do u guys have hard lumps undetneath still too?

[strahan222]

Ya I'm 4 weeks and 2 days and I got this hard stuff under my right nipple. I guess the best solution is just to wait it out and it should go away eventually. I'm pretty sure it's not glands cause it doesn't feel anything like glands. But it does look like glands from the outside so that's why it's pretty annoying to go through a surgery like that and still have that gland looking nipple for a while.

[gumtreeconfession]

I would really appreciate it if someone who posted regarding this problem, or alternatively someone who went through the same thing, could tell me (us?) if the swelling eventually went down after another few weeks/months.

I'm having the exact same experience. The nipples are looking good after I take off the vest but become puffy within 10-15 minutes. I would really like to know what the physical issue is here, is the way it looks moments after wearing the vest the way it'll eventually look? if so, I can wait another month or two patiently, but I just want to know it wasn't a bad surgery...

My surgeon told me to wait it out for another month, possibly two, before I see an ideal result, and I'm ready to do that - I would just like someone who's gone through this to ease my mind.

Thanks.

[DrBermant]

I would really appreciate it if someone who posted regarding this problem, or alternatively someone who went through the same thing, could tell me (us?) if the swelling eventually went down after another few weeks/months.

I'm having the exact same experience. The nipples are looking good after I take off the vest but become puffy within 10-15 minutes. I would really like to know what the physical issue is here, is the way it looks moments after wearing the vest the way it'll eventually look? if so, I can wait another month or two patiently, but I just want to know it wasn't a bad surgery...

My surgeon told me to wait it out for another month, possibly two, before I see an ideal result, and I'm ready to do that - I would just like someone who's gone through this to ease my mind.

Thanks.

Posting Standard After Gynecomastia Pictures can help others better understand your concerns.

In this situation, posting photos right after leaving the vest, and then another set 15 minutes later could show the issue.

Swelling after surgery can be managed by compression garments. How long such swelling lasts varies based on the original problem, what was done, skill of the surgeon and many other factors. I prefer techniques with Minimal Swelling and Bruising After Gynecomastia Surgery. That way the vest has less work for the protection component. But if tissues are flat when the vest first comes off, the they swell shortly after, it sounds like the tissue still needs compression for protection. Swelling is a sign of injury. Such reaction to the vest being off puts a patient in what I call Stage One of healing: the protection phase.

I see many patients who complain of residual "Swelling" Puffy Nipple Gynecomastia after another doctor's surgery.

Here is a new resource on Anatomy of Puffy Nipple Complication After Gynecomastia Surgery. It explains why targeting gland first is so important. If the gland is trivial, leaving it behind will not be a problem. This is not cancer surgery. However, gland does not compress like fat. Performing liposuction first tends to dig a hole for remaining gland. What may appear as a flatter contour, puffs out further as the pectoral muscles flex, arms raise overhead, or the areola muscles relax. It explains the reasoning behind my Dynamic Technique. The key to this Dynamic Technique is to target the gland first. It is not just simply evolving what happens during surgery based on what is found.

This page took me months to write. There is a great deal of content in this page.

Recently I have been reviewing requests for help from men unhappy after other surgeons' gynecomastia surgery. There were over 500 requests for my help! Many were for residual contour problems from failures of liposuction alone or partial gland excision with liposuction.

Here are just a few of the many examples I have seen and treated:

• Revision Gynecomastia After Failed Liposuction By Other Surgeon
• Revision Puffy Nipple Gynecomastia After Failed Liposuction By Other Surgeon
• Revision Gynecomastia After Liposuction and Partial Gland Excision By Other Surgeon.
• Revision Gynecomastia After Partial Gland Excision
  

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia Chest Sculpture

[gumtreeconfession]

Thanks so much for your reply, Dr. Bermant.

I will definitely look into these links you posted, while I hope for the surgery results to improve with time. I am only a month post-op tomorrow, so I will give it another month before coming on here again and posting pictures.

Thanks again.

[leaf]

There are three parties to any surgery:  the patient, the surgeon and Mother Nature.  Assuming the patient complied with all the post op instructions and assuming the surgeon did his job, then Mother Nature assumes some of the blame for a less that perfect result.

Early (within 1-2 months) after surgery. there may be some swelling under the nipples.  That is why it may improve with pressure (which "squeezes out" the swelling). 

Later on, I have found that sometimes there is a buildup of scar tissue under the nipples -- I can hypothesize about the cause but there is no absolute proof.  Bottom line is that scar tissue can develop beneath the nipple -- and the best treatment (at least in my hands) has been one or more injections of kenalog.

Dr Jacobs  

Dr Jacobs, could you explain your hypothesis as to which factor(s) or surgical technique could lead to scar tissue underneath the nipples?

Thanks, Leaf

[DrBermant]

Thanks so much for your reply, Dr. Bermant.

I will definitely look into these links you posted, while I hope for the surgery results to improve with time. I am only a month post-op tomorrow, so I will give it another month before coming on here again and posting pictures.

Thanks again.

One month again is very early.

Being patient is very important. Tissues do tend to evolve after any surgery. One of my tricks is to start out shortly after surgery with early results that already look good as you can see on my website. Even then, tissues tend to change and improve. I just prefer to get my patients starting further along the process whenever possible. That is why I track very early after surgery results and show them for all to see. How someone changes after another method can vary quite a bit and best understood by finding progressions of healing from that doctor.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery