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Hard Lumps After Gynecomastia Surgery

As a plastic surgeon specializing in gynecomastia surgery, I spend a lot of time answering patient questions through emails and various internet forums. One of the most common topics of conversation is feeling firm lumps after surgery. Obviously men who have gynecomastia are all too familiar with firm lumps in their breast, especially under the areola. Thus it can be very disconcerting to feel these AFTER surgery. There is a simple way to differentiate what the lumps after surgery are:

  1. If the results of the surgery were initially very good with no lumps felt then the formation of these lumps (sometimes as early as 2 weeks after surgery) is usually scar tissue build up.
  2. If the lumps were palpable right after the surgery and have never reduced then it is likely excess tissue that was not removed.

Now not every lump needs to be treated. The most important thing is not whether it can be felt, but whether it can be seen. If it is scar tissue formation, then typically starting with finger massage can help break it up. If there is no improvement with this technique then careful kenalog injections can be performed to break up the scar tissue. In my practice this is not done frequently, however, when it is, it can take sometimes require 2 or 3 injections spaced 1 month apart to fully dissipate the scar. Only, and only if these two techniques do not help, do I then recommend surgery to remove the scar. This is extremely rare. Obviously, if there is excess tissue that is causing a visible fullness, then further surgery would need to be done to address this. I recommend, however, that patients wait six months to perform this surgery to allow not only proper assessment of what to remove, but also allow the original surgical area to settle. To learn more about gynecomastia surgery and to see before and after photographs, visit www.losangelesgynecomastia.org.