Anchor Breast Lift Incision Separation. What To Expect After Debridement? (photo)

I had a small opening at the "T". I am NOT a smoker. Today I saw my PS and he thought that it was a suture not allowing it to heal. He debrided it. It is now a hole. I trust my doctor but it all happened so fast I forgot to ask some questions. Since he debrided does that mean I have some necrosis? Will it heel quickly now? Is this uncommon? I have a silver patch on it now. He wants to see me weekly now. I'm scared. Will it get bigger? I have no infection. Is the silver patch proper protocol?

Doctor Answers 10

Wound separation in anchor incision

Repeat after me:  "This too shall pass.  This too shall heal." 

This problem of spitting stiches and wound separtion can happen after just about any procedure where structures are lifted and/or tightened.   It is always very frightening for patients a it is for you.  Patients are almost always amazed that it does heal with time and often ends up looking JUST FINE.

If you end up "spitting" a lot of your sutures, make sure the surgeon writes they type of suture down for you.  Some patients are very sensitive to certain type of suture.  In my practice, Vicryl sutures cause the most problems.

Keep you appoinments with your surgeon, follow his/her instructions and have faith in Mother Nature and the mystical power of the body to heal. 

Seattle Plastic Surgeon
5.0 out of 5 stars 55 reviews

Anchor Scar Wounds

Hello CantWait77,

This is fairly common, and your surgeon might have touched upon this indirectly when talking about the possibility of unexpected scarring. This problem is due to the highest tension and the poorest blood supply to the skin flaps in the inverted T region. It sounds like your doctor is doing everything right: not ignoring it, debriding the necrotic tissue (which was apparently minimal from your photos), covering it, and following you closely.  This should heal in one to two weeks, and look angry for a few months before it starts to mature and whiten. Don't be scared, you'll be fine; you might not even desire any revision of this scar.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 45 reviews

Anchor ("Inverted T") Breast Lift Wound Separation

Unfortunately you are suffering a known complication of the procedure. I assume its possibility was discussed with you before the surgery and it certainly should have been discussed with you at your last visit. It is ALWAYS a good idea to go to your surgeon's visits with another person who can listen to the same information conveyed to you and ask questions you cannot think of asking because you may be overwhelmed.

Whenever Plastic surgeons lift skin off the underlying structures and close it with a vertical T pattern the blood vessels and circulations in this area are adversely affected. If further compromise is added by either swelling, tension, compression or underlying medical conditions such as Diabetes, Autoimmune diseases or ingesting/inhaling Nicotine can all bring about a critical loss of blood flow in that skin causing the death of that skin.

This APPEARS to be the case with you. The next step is to remove the dead tissue (surgical debridement) to limit the ability of germs to thrive in that area and encourage the inherent ability of the skin to heal itself (healing by secondary intention). Frequent small debridements of tissue which is not pink or red are required and can be done surgically, enzymatically by frequent dressing changes and by combination of these treatments. Using silver , as is done in your case, or in a cream (Silvadene) penetrates compromised, bloodless tissue killing bacteria and prevents infection.

As dark and scary as things look now, this is NOT permanent. You will heal. Do whatever your surgeon tells you to do and make sure you ask him/her any questions you have. I'm SURE he/she would be more than glad to educate you.

Remember, this is a temporary setback. It's NOT the ultimate result.

Peter A. Aldea, MD
Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 81 reviews

May need more time to heal

The wound looks clean and granulating.  If it is just not healing an excision can be attempted but there is always a risk that it could develop an abscess.  There are only three things that make wound not heal, cancer, infection or a foreign body.  Otherwise it should heal on its own.  Sometimes it just takes some time.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 13 reviews

Common issue after inveretd T surgery

This is unfortunately not a rare issue after an inverted T incision.  Good news is you doctor is taking the right approach and taking care of you.  This will heal in a few weeks time with appropriate wound care.

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 64 reviews

Anchor Breast Lift Incision Separation. What To Expect After Debridement

Thank you for sending your question and photo. . Separation in this area can occur with breast lift and implant surgery. Continue to  cleanse and apply silver dressing. Wash hands prior to application. Most likely, your wound will not get bigger.  It will heal in 3-6 weeks and it will hardly be noticeable.  If it is, then your surgeon can perform a small scar revision in 6 months.  Please discuss your concerns with your Plastic Surgeon.

Don't despair

You appear to have a common complication of breast lift or reduction, specifically delayed healing, most common at the " inferior T zone". Smoking is definitely a risk factor, so it is good that you do not smoke, but non-smokers of course can have healing issues. Your plastic surgeon is doing just tbe right thing with debridement (removal of dead "necrotic" tissue)' appropriate cleaning and dressings, and close follow up. With time you will heal fully and ultimately your scars can be revised as needed. This minor setback should not affect your overall result in the long run!

David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 33 reviews

Open wound after breast reduction

I know that this is very scary for you, but I would encourage you to be patient.  The corners where everything comes together at the inverted-T incision sometimes do open up -- usually because of ischemia or tension.  Fortunately, your body is really good at healing itself.  Once it is open, it will heal from the inside out -- it may take a few weeks though.  You can help it along by following your surgeons instructions, making sure that it is clean, and making sure that you have good nutrition and eat well. Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 13 reviews

Delayed Wound Healing after Breast Augmentation/Lifting?

Thank you for the question and pictures.
What you are experiencing can occur occasionally after breast augmentation/lifting surgery.  The delayed wound healing has to do with blood flow/tension in the area of the “T” junction. I think your surgeon is treating you correctly and I believe that you will be just fine after 2 to 3 weeks of healing.
I would suggest continued close follow-up with your plastic surgeon.  For real reassurance don't hesitate to express your questions and concerns.
Best wishes.

Anchor incision breakdown

The anchor incision sometimes breaks down at the "T." Yes, this means there was some skin necrosis.  Debridement of this dead tissue will allow things to heal properly.  It may take a few week.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.