At the Austin Gynecomastia Center, I have had the privilege of performing well over 350 gynecomastia surgery cases a year and have done so for quite some time. This has allowed me the opportunity to learn from my patients — after all, we call it a doctor’s “practice” for a reason.
Recent advances in the treatment of gynecomastia has gone a long way to reduce complications and improve the quality of the results. Fortunately, significant problems after gynecomastia treatment are uncommon. One challenging problem issue I encounter is scar tissue development after gynecomastia surgery that can compromise the result — often a firmness or mass in the tissue of the chest that can be felt and seen or sometimes just felt and not seen. It typically shows up after 6-8 weeks or longer after treatment. The normal time to full healing from gynecomastia treatment is 6 months to a year.
The photo sequence above is helpful is understanding what is going on. The first on the left is his chest before surgery, the second is a month later and the last on the right is 5 months from treatment. The arrow at the bottom of his chest is an area of scar tissue that developed. Of interest is the fact that before treatment his right chest was a lot bigger but now, because of treatment and the scar tissue, his left side is larger!
What is the cause of scar tissue development after gynecomastia surgery and how is it managed?
Scar tissue can develop as part of the normal healing process. Some patients make more scar than others. Fluid or blood that remains after treatment can promote scar tissue expansion. Those patients who experience a hematoma (blood collection) or seroma (fluid collection) after treatment are at higher risk for scar tissue formation.
Scar tissue formation after gynecomastia surgery is managed with 3 alternatives. First, manipulation of the tissue with massage, the roller device or even a power massage device can help to soften and “break up” the scar. Second, steroid injections can help to soften and dissipate the scar. This is an injection of steroids into the actual scar a few times waiting 2 months before repeat injections. The last resort is another surgical procedure to reduce/remove the scar tissue. There is an “art” to deciding what to do on a case by case basis because sometimes the “enemy of good is better” which means there are potential downsides to treatment using steroids and surgery. There is almost never a problem with massage treatment.
To summarize, scar tissue development after gynecomastia surgery is a known complication, it’s not necessarily unanticipated, and it’s best to catch it early while it is soft and evolving rather than waiting until it is fully matured and rock solid. Treatment alternatives exist. It’s not the end of the world. It will require time and effort on your behalf to move things along. Patience is a virtue.