Will skin retract post op?

[ap123]

Oh okay thanks a lot! I will be patient, was just wondering if that sped it up at all. So I will not ice anything. And my incisions were along my nipple. It looks like the outside of a quarter circle along each nipple's far side to the bottom's centre.

[1Wheels1]

Hey Dr Jacobs,

I'm going to see my surgeon again in a few days and my nipples are still puffy like they were post op. I just want to be clear about a few things so I am prepared to talk with him.

I understand that to get rid of puffy nipples the lipo is important. Am I right in believing that when you use it you are separating the tissues from the underside of the skin and the nipple? Is this the point you would expect to see the nipples retract to normal size given that there is nothing underneath for them to hold onto? I'm pretty certain that he neglected this technique and that's why my nipples never retracted but I just want to be clear on this so i can go to my appointment with the right knowledge.

[Dr. Elliot Jacobs]

Difficult to answer because I am speaking hypothetically.  All I can say is that sometimes, if excision for puffy nipples is the only thing that is done, then the puffiness may remain because the surrounding skin has not been lifted up (either with sharp dissection or with lipo using suction or non-suction) so that the surrounding skin can re-drape and redistribute.  The surrounding skin can then exert some pull on the now flattened areola and keep it flat.  If this is not done, then the areola (even with the underlying excess tissues removed) has nowhere to go and may remain puffy.  It is also an invitation for scar tissue to develop.

Dr Jacobs

[ap123]

I had mine on the bottom of the nipple

[Neil123]

This is a very interesting discussion and I feel Dr. Jacobs is helping very much sharing from his expertise.

To be honest, I must add I am shocked. Perhaps one of the doctors can answer this. How in the world did this doctor he went to do it without lipo!!?? how evil. sorry I just don't get it! like he didn't know this will happen. even I would know now after reading Dr. Jacobs comments.

Lastly, can you pls attach a picture or two again, were your pics removed by mistake by this website?

Thanks & Regards,
N.

[1Wheels1]

Hey Dr. Jacobs
    I'm very nearly at the 6 month mark since my surgery and I sadly report that my nipples have remained puffy and now have a looser look and feel to them. My first question for you is:

If I was to undergo a revision surgery and get my surgeon to simply detach the skin and nipple from the underlying tissues using the lipo method you described earlier, do you think that the retraction of the areola could be achieved? Would I be correct in assuming that this is a common revision technique? (obviously I don't understand the complexities of this surgery but to me it makes sense that this could work given what you've explained to me) or am i wrong and this would cause more harm then good seeing as I've already had the tissues removed and the healing has taken place...?

I really feel like it's as simple as opening me up again, separating the skin from the underlying tissues, and then wearing a tight compression vest for the healing (which i neglected last time).

Again I know that it's very difficult for you to answer such personal questions but I'm only asking in a general sense. Could this work and have you seen it work? I know that you have much knowledge and experience in this area and I'm hoping that you'll be able to tell me if what I am suggesting is a realistic option.


My second question is regarding the scarring. My right side looks very good but my left healed a little bit funny. (the upper part of the nipple healed slightly over top of the incision giving it a raised up look and allowing some scar tissue to be noticeable. While I am undergoing my revision, is it possible for my surgeon to cut away the offending scar tissue, then reattach both sides of the incision so that they meet evenly again?

[Dr. Elliot Jacobs]

is it possible for my surgeon to cut away the offending scar tissue, then reattach both sides of the incision so that they meet evenly again?

Yes, this or some variation thereof could be done.  This is called "scar revision" and most plastic surgeons are conversant with the techniques involved.

As for your first question, one would have to evaluate you to see what needed to be done.  Certainly, it is possible that addition loosening of surround skin might be needed -- but also there might be residual gland and/or scar tissue directly beneath the areola as well.

Dr Jacobs