Every one of our man boob patients can expect swelling after surgery, as can every guy around the world who goes under the knife for gynecomastia treatment. Occasionally, no matter how experienced the plastic surgeon, fluid builds in a specific location in addition to out among breast tissues. Localized fluid accumulation is either a seroma or hematoma. Understandably, a mound of squishy fluid or a lump that may be painful can be alarming for a guy.
Here are our thoughts.
Traumatized tissues weep. Anyone who has suffered a “raspberry” — a scrape that removes the top layers of skin without going deep enough to draw very much blood — will probably have experienced a wound that yields a bit of clear fluid called serum. After a surgical procedure, this also happens internally and swelling is the result. A seroma is a pocket of this fluid.
Seromas are eventually reabsorbed by the body (just as more widespread swelling will be). In many cases we advise watchful waiting, with an over-the-counter pain reliever if there’s any discomfort. If the mound or lump is large and bothers a patient, serum can easily be aspirated with a fine needle in a post-op appointment.
Obviously, some amount of internal bleeding is to be expected after surgery as well. It’s usually minor, stops very quickly and is absorbed by the body over time just like serum is. Hematomas result when blood collects in a prominent pocket. Patients can experience a large or smaller lump, sometimes bruised-looking, sometimes painful.
The question is, what to do about a hematoma? In the rare cases we see in our man boob patients, we often elect to drain the excess blood right away through needle aspiration. If time passes, blood tends to coagulate into a jelly-like substance. It may still be removed but it’s likely to require a small incision and local anesthesia. We like to drain hematomas as they arise not only to avoid this, but because it’s thought that the presence of excess blood will lead to additional scar tissue development down the road if left untreated.
The main risk of draining fluid after gynecomastia surgery is infection. We take every precaution against this eventuality, however, and we give our patients detailed after care instructions. Our infection rate associated with draining seromas and hematomas is very nearly zero.
If you’re concerned about developing a seroma or hematoma, be sure to talk it through with your plastic surgeon and get his or her input on your particular level of risk. If you have developed a seroma or hematoma in the past, it’s certainly worth mentioning. That’s one factor. Taking certain medications, particularly blood thinners such as aspirin and warfarin, can also contribute to additional bleeding after surgery, as can a few diseases, according to emedicinehealth.com.
We are happy to inform our patients that they are unlikely to experience localized serum or blood build up. That’s due to the fact that most guys we treat for man boobs require tiny incisions and minimal disruption of tissues under the skin. It’s also because we have been performing man boob surgery for more than 30 years and we know how to get the best results for our patients while causing the least tissue trauma possible.
You can help minimize overall swelling, and possibly the risk of seromas and hematomas, by following your plastic surgeon’s post op instructions. Wearing your compression garment for the prescribed period of time is one of the best steps to take.
Want to have a conversation about man boob surgery with our team? You can start by filling out the short contact form on this site. We’ll get right back to you!
Dr. Elliot William Jacobs is a board-certified aesthetic plastic surgeon who specializes in FTM top surgery, gynecomastia surgery, revision gynecomastia surgery and male breast reduction. He is a native of New York and has over 40 years of experience in his field. Dr. Jacobs is a highly respected and sought-after surgeon who is known for his skill, experience, and compassion. Whether you are interested in gynecomastia for the first time, or are looking to correct a gynecomastia you aren’t happy with, Dr. Jacobs can deliver amazing results.
DR. ELLIOT JACOBS M.D., F.A.C.S., F.I.C.S
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