Author Topic: Revision Surgery Questions  (Read 6125 times)

Offline SecondPlace

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Ok, so I think the gland in my right nipple is reappearing.  As of right now, I can live 100% on what nipple looks.  There is only slight amount of gland I believe.

I had surgery 10 months ago, and the other day I feel some rubbery mass underneath my nipple.  It is also very sore.

1) Will the gland continue to grow?

2) If I get a revision surgery, will I have to go through the same recovery steps like last time. (wearing vest for 6 weeks... etc)

DrBermant

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I had gyne surgery 10 months ago.  All scar tissue seemed to have gone away 2-3 months ago and everything looked good.  Yesterday morning I woke up with my right nipple very sore.  Now on the bottom part of my nipple, there is something there.  Could this be random scar tissue?  Could the be gyne again!?

Also, should I take an estrogen blocker to stop any gyne that is forming!?  I know steroid users do this to not get gyne.  Also, where would I buy estrogen blockers at?

Ok, so I think the gland in my right nipple is reappearing.  As of right now, I can live 100% on what nipple looks.  There is only slight amount of gland I believe.

I had surgery 10 months ago, and the other day I feel some rubbery mass underneath my nipple.  It is also very sore.

1) Will the gland continue to grow?

2) If I get a revision surgery, will I have to go through the same recovery steps like last time. (wearing vest for 6 weeks... etc)


Discomfort and growth of tissue after surgery can be among signs of recurrence. Growth tends to be gradual, not overnight. There are other conditions that can cause tenderness and discomfort.  Self treatment is not a good idea. Options depend on many factors best discussed with someone who has experience in diagnosis of such issues.  If there is a factor causing gland growth, then that gland can continue to grow as seen in
the examples below.

Recovery after revision surgery can be more complex or much more simple. Most of my revision surgery patients tell me that recovery after my operations was with more comfort, less swelling, and easier return to activities than their other doctors' operations.

I caution each of my patients that surgery does not typically stop male breast growth.  If there is a problem with growing breasts, recurrence can happen.  Any of these medical problems and or these medications can cause gynecomastia. So, if you want to get worried about regrowth, you could get yourself evaluated for each of these conditions to see if they could be a factor. 

If you are using something that can stimulate breast regrowth, shreds of gland remain behind with any surgical technique.  It is just not practical to remove all elements of gland.  The problem is that there are fine fingers of gland that dissect between fingers of fat and can extend quite far into the chest. Take a look at the Anatomy of Gynecomastia to see what I mean.  Even with a radical mastectomy (a disfiguring technique used for some male breast cancer problems), some gland can remain.  Surgery also does not prevent weight gain in the chest.  Men tend to put weight on the belly and chest regions.  I educate each of my patients that this surgery will not prevent further breast growth.  It is like changing/fixing a tire with a nail.  Fixing/changing the tire will not prevent you from getting a new nail in that tire.

Regrowth of gland from stimulation can occur where shreds of gland remain behind. This can be behind the areola, along the deeper edges or margins of a zone of excision. 

I take care of many patients with gynecomastia, as many as 8 in one day alone.  With all the gynecomastia surgery I have done, it is very rare to have regrowth for patients I have sculpted.  One patient (who had surgery on only side by another doctor) came to me with pro hormone induced gynecomastia that only came back on the side that had no surgery.  His growth was massive on the one side and none on the other.  His surgery by that other doctor had left a massive crater - the skin was adherent against the chest wall with normal fat surrounding the ugly deformity.  One side looked like the deformity seen here.  The other side was almost a B cup breast so tender that I could barely examine it.  As with each patient who presented to me with current breast growth, he was referred for an endocrinology evaluation and stabilization before considering surgery.  I do not know if such radical surgery was a factor or not.   Even if it did, removing all fat under the skin just gives an unnatural look.

Here is another example of Gynecomastia Breast Regrowth on my site.  Caution this is a graphic picture of the massive gland regrowth removed on the operating table.

This patient is rather unusual. He was a misdiagnosed genetic female who has lived his entire life as a male.  His birth certificate says male as does his driver's license. Yes, a terrible mistake labeling him male made from birth and early on not recognizing his Congenital Adrenal Hyperplasia.  His body has been exposed to high levels of androgens and estrogen since within his mother's womb. This results in an a condition better called Intersex than the older phrase Hermaphroditism.

I prefer to target the gland first with my Dynamic Technique. This permits me to remove most of the gland and then sculpt the remaining tissue to minimize contour problems.

By concentrating on the gland first I am able to minimize the chance of breast regrowth.  It is very rare for my patients to have recurrence.  With my techniques and my Red Flag Evaluation System before surgery, I have only a few patients over the many years I have been doing surgery that I know have regrown.  However, gynecomastia surgery does not stop breast regrowth.  For patients having breast growth, I have advised for many years that they should get their problem under control before surgery.  There are exceptions, such as young men with massive breasts that have not stopped growing.  That is why each case needs to be individually evaluated. 

Prevention and stabilizing the problem(s) causing gynecomastia, when possible, is much better. We help patients explore such issues during consultations or preliminary remote discussions.

Hope this helps,

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

Offline Dr. Elliot Jacobs

  • Elliot W. Jacobs, MD, FACS
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I like simple answers.

If it looks good and you can just barely feel something, don't worry.  This surgery is done to make you look good -- no-one goes around "testing" your nipples.

If you should begin to see a bulge or experience some pain or tenderness, then return to your surgeon for his evaluation.  Most often this would be scar tissue and not re-growth of tissue.  And if this occurred, more often than not, a simple injection of kenalog (or similar) would help -- but rarely is surgery required.

Relax -- it's summer -- go out and go swimming -- bare chested!!!

Dr Jacobs

Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
4800 North Federal Highway
Boca Raton, Florida 33431
561  367 9101
Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.c


 

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