Advice re: compression vest post-op

[ha03274]

I'm now a week and a half post op from my gland excision + lipo with Dr. Karidis. I was given 2 Macom compression vests - a small and a medium. Initially with the bandages/padding the small fitted very snug post-op but next day these were removed so I could shower as per post-op instructions. I've since been wearing the small vest every day (except to shower in the mornings and quick hand wash/dry) and whilst tight when sitting/standing, when lying in bed with my head propped up with 2-3 pillows, it feels loose over the upper part of my chest.

I'm concerned it's not providing compression to minimise swelling and improve skin retraction although so far chest has stayed nice and flat. I'd say the small is the correct size for me as it is snug when sitting/standing (plus my slight gut would not fit in an XS). Is it normal for the vest to feel looser when lying down? If not, what can I do to improve this except buying a smaller/different compression vest?

Sorry for the long post and I would appreciate any advice!

[Askone]

My Macom vest feels similar if I lie down. I'm on day 7 tomorrow, so am wearing the chest binder on top of the macom, which is providing excellent chest compression

[ha032742]

For some reason I can't access my original account so had to setup this one

Thanks for your reply, Askone, feel reassured now

[AchillesUK]

The vest should be quite tight, I'd be a little concerned if it was loose in any position, especially in the first few weeks.

Certainly wearing the binder on top is a first step. Everyone's (post-op) chest is a different size so there may be some loose areas. Mr Levick provided large square shaped bandages for me to use and a couple of his other patients. If you look on my thread (somewhere in there ) I've posted pictures of using all 3 'layers' - bandages, vest and binder.

[ha032742]

Dr. Karidis does not provide a binder unlike Mr Levick, just a compression vest post-op...in fact, I got the impression during my consultation that Dr. Karidis does not think that prolonged compression is crucial to recovery as he said that patients often stop wearing the vest after 10 days or so (earlier than the recommended 24 hours a day for 14 days followed by 12 hours every day for a further 2 weeks in the post-op instructions) with usually no impact on the contours of the chest in the majority of cases (obviously someone who had a lot of gland removed/suffered post-op complications such as a haematoma would probably need to have it on longer). Anyway, since my last post I've started wearing a very tight Nike compression short sleeve top under the Macom vest and it seems much more supportive...I'll probably carry on wearing the vest 24/7 for another week or so (3 weeks in total) and then switch to wearing it for 12 hours at a time.

[AchillesUK]

Dr. Karidis does not provide a binder unlike Mr Levick, just a compression vest post-op...in fact, I got the impression during my consultation that Dr. Karidis does not think that prolonged compression is crucial to recovery as he said that patients often stop wearing the vest after 10 days or so (earlier than the recommended 24 hours a day for 14 days followed by 12 hours every day for a further 2 weeks in the post-op instructions) with usually no impact on the contours of the chest in the majority of cases (obviously someone who had a lot of gland removed/suffered post-op complications such as a haematoma would probably need to have it on longer). Anyway, since my last post I've started wearing a very tight Nike compression short sleeve top under the Macom vest and it seems much more supportive...I'll probably carry on wearing the vest 24/7 for another week or so (3 weeks in total) and then switch to wearing it for 12 hours at a time.

Mr Levick's own mantra is that you can never have enough compression for as long as possible.

However, the best thing you can do is follow your own surgeon's advice.

Dr. Karidis is a very experienced surgeon in his own right. He has his own technique (I believe he cuts around the nipples?) and so his advice maybe be based on his particular method of surgery/experience.

[ha032742]

He makes an incision approximately 15-20mm in size at the inferior border of the areola and takes the gland out piecemeal (as well as an incision near the axilla for the lipo)...this way he can directly see the gland and also ensure that a small amount is left to prevent a nipple deformity post-op. My scars are virtually invisible 2 weeks post-op.

So far so good with regards to swelling/scar tissue so I will follow Dr. Karidis' post-op instructions.

[ha032742]

So I think scar tissue is now setting in...I noticed hard ridges from the edge of the areola towards the axilla on both sides today. I've been massaging for the past few days so will hopefully settle down with time.