Post-Surgical Adhesion After Gynecomastia Surgery: Causes, Symptoms, and Solutions
This type of adhesion is different from the BioBond mentioned in a previous post. While BioBond is used to facilitate healing and tissue bonding in a controlled manner and typically dissolves within 2-4 months, post-surgical adhesions occur when tissues unintentionally stick together and may persist for over six months, potentially causing discomfort and movement restrictions. While BioBond is used to facilitate healing and tissue bonding in a controlled manner, post-surgical adhesions occur when tissues unintentionally stick together, potentially causing discomfort and movement restrictions.* While BioBond is used to facilitate healing and tissue bonding in a controlled manner, post-surgical adhesions occur when tissues unintentionally stick together, potentially causing discomfort and movement restrictions.*
Some patients experience adhesion (post-surgical tissue sticking) after gynecomastia surgery, where the skin adheres tightly to underlying structures. This can cause discomfort, restricted movement, and concern for patients. However, in most cases, proper management can resolve the issue. This post explores the causes, symptoms, prevention methods, and treatment options for adhesions after gynecomastia surgery.
Causes of Adhesion
Dr. Francis Jeon’s Insight
- “In gynecomastia surgery, determining how much fat to leave behind is crucial. While removing as much fat as possible may be beneficial for achieving a more muscular chest appearance, fat also plays a protective role for the skin.
- Particularly around the areola, where there is little fat and the glandular tissue is directly attached to the skin, adhesions are more likely to form after gland removal.” Post-surgical adhesions typically result from the following factors:
1️⃣ Damage to the Subcutaneous Layer
- The area around the areola has relatively little fat, and glandular tissue is directly attached to the subcutaneous layer. This makes it more susceptible to damage during the dissection process.
2️⃣ Bleeding and Hematomas
- If bleeding occurs, hematomas may form. During the absorption process, fibrotic scar tissue can develop, leading to adhesions.
3️⃣ Persistent Seroma
- If a seroma remains for an extended period post-surgery, it may not be fully absorbed, causing adhesion between tissues.
Symptoms of Adhesion
✅ Skin Color Change
- Due to impaired blood circulation caused by adhesion, hyperpigmentation (darkening) or hypopigmentation (lightening) of the skin may occur. Adhesions can present with the following symptoms:
✅ Skin Dimpling
- The affected area may develop an inward depression due to tissue contraction.
✅ Pain and Restricted Movement
- The skin and fascia of the pectoralis major muscle can become tightly bound, causing discomfort and pain when moving.
- This pain can make stretching and massage difficult, leading to a vicious cycle of worsening adhesions.
Prevention of Adhesions
At Evita Clinic, the following measures are taken to prevent adhesion:
Application of Anti-Adhesion Agents During Surgery
- To prevent adhesions, an anti-adhesion agent is applied beneath the areola at the end of the surgery. This method is commonly used in procedures like C-sections and thyroid surgeries.
24-Hour Post-Surgical Compression Garment Use
- Wearing a compression garment minimizes swelling and micro-bleeding, which reduces the risk of hematomas and seromas.
Massage Starts 2-3 Weeks After Surgery
- Massaging or applying excessive force too early may actually worsen scarring. It is recommended to start gentle massage and stretching 2-3 weeks after surgery for best results.
High-Frequency Therapy and Injectable Treatments
- If necessary, high-frequency therapy or hyaluronidase injections can help break down adhesions.
Treatment Options for Adhesions
Adhesions do not always require surgical intervention. Most cases can be managed through the following methods:
✔ Massage and Exercise
- Since adhesions worsen if left untreated, appropriate massage and light exercises can be highly effective.
✔ High-Frequency Therapy and Injections
- High-frequency therapy or hyaluronidase injections can help release the adhesion.
✔ Surgical Intervention for Persistent Adhesions
- If adhesions persist for over six months despite treatment, surgical release, fat grafting, or filler injections may be considered.
Dr. Francis Jeon’s Advice
- “Are you worried about post-surgical adhesions after gynecomastia surgery? Don’t be too anxious. When we examine adhesion cases during surgery, they often resemble frozen shoulder (adhesive capsulitis).
- Patients with frozen shoulder struggle to lift their arms due to pain, but with consistent physical therapy and movement, symptoms usually improve within a year.
- The same principle applies to post-gynecomastia surgery adhesions. Rather than expecting a quick fix, gradually increasing mobility, combining massage with light exercise, and being patient will lead to improvement over time. Don’t rush—take it step by step!”
Frequently Asked Questions (Q&A)
❓ Do adhesions always require revision surgery?
➡ No, most adhesions resolve naturally with massage and exercise. Surgery is rarely necessary. At Evita Clinic, we monitor patients for up to a year post-surgery before considering revision surgery.
❓ Can massage help prevent adhesions?
➡ Yes, it can. Adhesions develop when tissues remain stuck in place for an extended period. Proper massage promotes flexibility and reduces the risk of adhesion.
❓ What happens if I start exercising too soon?
➡ Exercising too soon can cause swelling, seroma formation, and excess tension on the surgical incision. This may lead to hypertrophic scars or widened scars. It is recommended to start light exercises and stretching after one month post-surgery.
Final Thoughts
Adhesions are a possible complication after gynecomastia surgery, but they can be prevented and treated with proper care. Wearing compression garments, appropriate massage, and timely treatment can significantly reduce the risk of adhesion.
If you are concerned about adhesions or experiencing symptoms, don’t worry—reach out to Evita Clinic for guidance. We are here to help ensure a smooth recovery!