Postop swelling or "leftover tissue"?

[amd]

Hi all!

I had DI with free nipple grafts on 9/4 and have a puffed-out area under my right armpit that worries me.  It's not a seroma. one doc tried to drain it then referred me for ultrasound guided drainage, and that doc said it wasn't a "pocket of fluid" like a seroma is, but instead general swelling, muscle swelling, and "leftover tissue."  He didn't seem like he'd necessarily dealt with many transfolks (he was an interventional radiologist), but it stressed me out that maybe my surgeon left a blob of fat or tissue behind and I will need a revision.

Has anyone else had really specific, localized swelling like this that did resolve itself?  Thanks in advance for any info.

[Bimmer Guy]

Hi all!

I had DI with free nipple grafts on 9/4 and have a puffed-out area under my right armpit that worries me.  It's not a seroma. one doc tried to drain it then referred me for ultrasound guided drainage, and that doc said it wasn't a "pocket of fluid" like a seroma is, but instead general swelling, muscle swelling, and "leftover tissue."  He didn't seem like he'd necessarily dealt with many transfolks (he was an interventional radiologist), but it stressed me out that maybe my surgeon left a blob of fat or tissue behind and I will need a revision.

Has anyone else had really specific, localized swelling like this that did resolve itself?  Thanks in advance for any info.

Yes, it is a very common swelling area and it takes time (sometimes months) to go down.  Who was your surgeon?

[amd]

Thanks for the quick reply, Brett. I went to Garramone. When I first emailed him the picture, he thought it was a seroma and recommended I go to someone locally to have it looked at/drained. I guess the odd comment of the interventional radiologist about it being "leftover tissue" just made me nervous. To clarify, I asked him, "like what, fat?" And he said yes.  But based on what some other folks have said, I am hoping it's still postop swelling.

[Bimmer Guy]

Thanks for the quick reply, Brett. I went to Garramone. When I first emailed him the picture, he thought it was a seroma and recommended I go to someone locally to have it looked at/drained. I guess the odd comment of the interventional radiologist about it being "leftover tissue" just made me nervous. To clarify, I asked him, "like what, fat?" And he said yes.  But based on what some other folks have said, I am hoping it's still postop swelling.

Hi, there.  I have had what I believe to be extra skin on the sides, but to me it doesn't look that different from a lot of other guys.  I want it to be gone, however.  Read post #518 page 26 of the Top Surgery Recovery thread.  The very last part of the post is me talking about wanting to get the area liposuctioned and I have a picture.  However, note that I am accentuating the fat as much as possible with the way I positioned my body.  It doesn't look that bad regularly.

I still think there is a good chance yours is post op swelling.  It is SO early in the game for you.  I would definitely call back to Garramone.  You should let him know what the other physician said and see what he says.

Try not to stress, they say it can take up to a year when it comes to swelling and my girlfriend swears mine is even less since that picture was taken.  I have to get her to take a present picture of me so that I can compare.

[amd]

Hi again, Brett,
I checked out your pic and the description in the other thread.  Your chest looks great!  My little tissue blob is similar to the tissue you highlight there, except so far for me it's only above the incision line, and more forward in my armpit, if that makes sense.  (I would post a picture, but I just got traumatized going on imgur. I had never heard of it, but heard you had to make images public for people here to see them, and people started peppering me with comments right away about if the image was "nsfw" because it had female nipples in it.  I took the whole thing down immediately. Holy cow.)

I did talk to Dr. Garramone again, and he said that it is very early for my healing to know what will happen with that swelling/tissue.  He did say that in that particular spot, it could be lymph nodes and lymphatic tissue that he left alone.  He said that in breast cancer surgeries, they remove some lymph nodes and lymphatic tissue, but in top surgery, that would only cause possible problems (like lymphedema, where your arms swell up because you don't have enough lymph nodes and tissue to process the fluids that circulate around your chest/arms).  His answer made sense to me.  The bottom line is definitely "keep calm and wait for more healing," but it helps to know the options of what it might be. Thanks again for the info/responses.

[Bimmer Guy]

Hi again, Brett,
I checked out your pic and the description in the other thread.  Your chest looks great!  My little tissue blob is similar to the tissue you highlight there, except so far for me it's only above the incision line, and more forward in my armpit, if that makes sense.  (I would post a picture, but I just got traumatized going on imgur. I had never heard of it, but heard you had to make images public for people here to see them, and people started peppering me with comments right away about if the image was "nsfw" because it had female nipples in it.  I took the whole thing down immediately. Holy cow.)

I did talk to Dr. Garramone again, and he said that it is very early for my healing to know what will happen with that swelling/tissue.  He did say that in that particular spot, it could be lymph nodes and lymphatic tissue that he left alone.  He said that in breast cancer surgeries, they remove some lymph nodes and lymphatic tissue, but in top surgery, that would only cause possible problems (like lymphedema, where your arms swell up because you don't have enough lymph nodes and tissue to process the fluids that circulate around your chest/arms).  His answer made sense to me.  The bottom line is definitely "keep calm and wait for more healing," but it helps to know the options of what it might be. Thanks again for the info/responses.

No problem, my friend.  Thank you for the compliment.

[aleon515]

I had swelling under my right arm for quite awhile but i just waited. It looked like it wouldn't go down. But eventually did.

--Jay

[Ayden]

I still have some swelling. My scars are separated and I was convinced that I still had left over tissue. I've noticed that it has gone down over the last month and even the area under my arms looks better.

[amd]

Thanks for all the reassurance, it helps. I am trying to be patient.

Here's my chest now:
http://s1381.photobucket.com/user/amd22/media/Mobile%20Uploads/YXV0b2NvbXByZXNzMTQxMjg2OTkzNDg1MS5qcGc_zpsfb1dd530.jpg.html?sort=3&o=0

[Ayden]

Amd: I can't view the picture but I'm on my phone.

How do you feel? Recovery is a b*tch and it takes time. Keep your head high, man.

[amd]

Ayden, thanks for letting me know the link didn't work. Hopefully this one will.

I am feeling better all the time. I had more pain, I think, than a lot of people I hear talk about it. I finished one set of the pain meds and even refilled it. I am taking just Tylenol now, but that surprised me.

[Ayden]

Hey man. You look great. I had swelling on my left side similar to what you have. It's gone down a fair but just in one month.

I surprised dr. G in that I could feel everything during my reveal. Drain removal make me sick and the nip dressing removal had me on the edge of nausea. He told me its uncommon to feel as much as I could but not unheard of. I would personally recommend ibuprofen or another NSAID for inflammation. Of course ask before you go that route. I did and it helped a lot, but I wouldn't do it unless you asked the doc first.

[amd]

Hey man. You look great. I had swelling on my left side similar to what you have. It's gone down a fair but just in one month.

I surprised dr. G in that I could feel everything during my reveal. Drain removal make me sick and the nip dressing removal had me on the edge of nausea. He told me its uncommon to feel as much as I could but not unheard of. I would personally recommend ibuprofen or another NSAID for inflammation. Of course ask before you go that route. I did and it helped a lot, but I wouldn't do it unless you asked the doc first.

Thanks! I am happy with it overall.

I def felt the drain removal too. Pain, not just odd like some ppl say. I think they had already started healing in me.

The NSAID isn't a bad idea. I had been avoiding them out of fear of bleeding, but Dr.G really only said to stay away from them for 2 weeks.

[Alexthecat]

Thanks! I am happy with it overall.

I def felt the drain removal too. Pain, not just odd like some ppl say. I think they had already started healing in me.

The NSAID isn't a bad idea. I had been avoiding them out of fear of bleeding, but Dr.G really only said to stay away from them for 2 weeks.

It was like the burning of 1000 suns when they were pulled out. Had them in for a week though.

[AleksiJason]

I had the same problem AMD.....went to the doc at about a month post op and she told me it was leftover tissue.....called Dr. G he told me the exact thing he told you....most of it went down but still have some left but was mostly swelling.....do you have an updated photo?

[amd]

I had the same problem AMD.....went to the doc at about a month post op and she told me it was leftover tissue.....called Dr. G he told me the exact thing he told you....most of it went down but still have some left but was mostly swelling.....do you have an updated photo?

Hey Aleksi,
In doing some research, I found out it could be (TW dysphoria) "accessory breast tissue" in my armpit which was there pre-op.  I can actually see a little bulge of tissue in my armpit in the pre-op pictures I took, which I never really noticed because I was much more concerned about the much larger tissue of my chest overall, obvs. 


Anyway, apparently this tissue can be present and be in the armpit, off to the side, etc, in up 2-6% of people assigned female at birth. 
http://journals.lww.com/plasreconsurg/Fulltext/2011/07000/Accessory_Breast_Tissue_in_the_Axilla_.88.aspx

Anyway, the swelling did go down some. This next photo is me at 17 weeks postop.  You can still see the tissue, but it's not as prominent. It's definitely still a bulge rather than a straight pec line, as you can see on my left side (right in the picture).  In talking more with Dr. Garramone, he said if I wanted, he would do a revision to remove the tissue. I would only have to pay the OR fee, which would be less (estimated $1100).  I just started T about 2 weeks ago, so I am thinking I will see if my body shifts at all with that and then think about a revision.



Also, in the photo, you can see my scar healing.  Under my right nipple, I had a little patch of hypertrophic scarring (raised area).