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Incision Looks Infected 3 Weeks After Breast Lift- Opinion? (photo)

Hi there, I need some advise on my breast. I had surgery oct 14 th, 2011 (almost 3 weeks ago), My incision doesn't look good, they getting worst. I called Dr. but then they told me that its fine and it heals that way. But I don't know what to think about that? Please help me, this is actually my second surgery, my first was 4 month ago, i wasn't happy with the result because they did areola lift ( that didn't help at all with my saggy breast) Now i had full lift. :(

Doctor Answers (11)

Possible breast lift infection?

+4

I'm sorry you have had to undergo a second operation to achieve the degree of lift you wanted and apparently needed. Your incision does not look infected, but there are incompletely-healed areas that could become infected as they are still open and normal circulation is not yet restored to these areas, which is why they have had difficulty healing thus far. This is not uncommon, and your surgeon needs to not only reassure you, but give advice to keep this from turning into a problem.

Some practical hints: If you are a smoker, or even exposed to second-hand smoke, you MUST discontinue this immediately. As I noted above, the inverted-T area of a Wise-pattern (anchor pattern) mastopexy is the area of least-robust circulation. Because of this the vertical scar actually heals with the finest and least-visible scar, BUT first it must heal. It can't do so without circulation. If you're not smoking or around smokers, or using nicotine patch, spray, gum, etc., good for you. If you are, stop IMMEDIATELY! But this area is still partially open, and susceptible to becoming infected.

Keep these areas clean. If OK with your surgeon, wash gently with soap and water (not hydrogen peroxide), pat dry, and keep a clean gauze dressing on the incisions. I'd advise NO antibiotic ointment, especially triple antibiotic ointment (such as Neosporin or Mycitracin). No ointment at all because chronic use can cause the wound to soften and separate further, and can (with chronic use) even stimulate an allergic reaction, which "looks" like an infection. So you use MORE ointment and it gets worse, not better! (Because it's an allergic reaction, NOT an infection). Triple antibiotic only gives you 3 times the likelihood of stimulating an allergic reaction, so cleanliness is better than gooping-up with antibiotic ointment. No hydrogen peroxide because it not only kills germs, but also inhibits epithelial cell growth and can actually slow healing. The exception can be an actually purulent (pus) wound, but then only once or twice with peroxide until it's clean.

Although it truly does not look infected, the tissues are compromised, which is to say that they are more susceptible to infection than the other areas of your incisions that are nicely intact and further along in their healing. So, while I am stressing that I am NOT recommending oral antibiotics because I think there is an infection here, I would recommend a broad-spectrum antibiotic to MINIMIZE the chances for these areas of incomplete healing to become infected. Just good common sense precaution, IMHO. If implants are involved, this is even more critical, to minimize potential contamination/infection that would require removal.

If fever, chills, or purulent drainage is noted, this should be cultured by your surgeon and appropriately-chosen antibiotic treatment instituted promptly (which might mean a change from the "prophylactic" antibiotic recommend earlier).

Wear a lightly-supportive cotton stretch bra without underwire. Avoid lifting, straining, or activities that might stretch the breast incisions. You are only 3 weeks out from surgery so your incisions are not yet durable, and these even-less-durable areas should be checked at least weekly, or more if needed or if they change.

Although there may be slightly more scarring in these areas, you will be amazed how much better they end up than how you think today they will look when finally healed. So be patient, see your surgeon regularly, and follow his or her advice. Ask about the hints above if they disagree with your doctor's advice. Good luck!


Minneapolis Plastic Surgeon
5.0 out of 5 stars 109 reviews

Breast lift and wound problems

+3

Is not uncommon to have problems with wounds after a breast lift. These rules may be due to a decreased blood supply in the flap to tension in the world are to both.

Infection is the thing that you must be concerned with. Watching for drainage, redness or fever would be evidence of infection. Keeping the wound covered with antibiotic ointment may be a good idea. Letting this would heal on its own is the best way to deal with this type of would. Once its healed the scar can be revised to approve its appearance.  Monitor your wound and follow-up frequently with you Dr. to make sure your wound is healing well.

Wendell Perry, MD
Miami Plastic Surgeon
5.0 out of 5 stars 136 reviews

Wound separation following a breast lift

+2

Though the lighting is not the best, it does not grossly appear as if your incision is infected. There is inflammation, wound separation and delayed healing - not uncommon occurrences in this area. Ultimately, it should close without major issues provided that an infection doesn't develop. Smoking or exposure to smoking can create/exacerbate this problem so if these apply to you - take note.

You surgeon needs to keep a fairly close eye on this. If you start to see intense redness or the a sizable amount of the surrounding tissues become hot and red - this would need to be treated aggressively and your surgeon should be notified immediately. (Fortunately, this is a fairly uncommon occurrence.)
 

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

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Infected incision

+2

It looks like your wound has broken down a little bit where there is the most tension, combined with a spitting suture.  It does not look infected overall based on your photo- but you could use some wound care in that area.  I would see your plastic surgeon and have them check for any deep suture that may  need to be removed under the open area.  Make sure your bra is not rubbing on or irritating the area and making things worse.  Good luck!

Tiffany McCormack, MD
Reno Plastic Surgeon
5.0 out of 5 stars 21 reviews

Healing problems after a breast lift

+2

The 'T' pattern breast lift, or breast reduction can place tension at the junction of the T and when wound separations occur this is where we see them. They can indeed start with a suture abscess, or an infection in the closure. We cannot tell if there is an active infection so your surgeon should be seeing things frequently and helping you along. After healing a revision of the scar is likely.

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

Infection in scar from breat lift

+2

Hi

There is some wound break down in the scar and the area is inflamed. This is a relatively common complication. This does not look overtly infected. But if you get any pain, if the area feels hot to touch, if there is a lot of discharge, particularly foul-smelling discharge - please see your surgeon straightway.

 

Anindya Lahiri, MBBS
Birmingham Plastic Surgeon
5.0 out of 5 stars 5 reviews

Is My Breast Lift Incision Infected

+2

Good Morning and thanks for the question and accompanying pictures.  It does not appear that your breast incisions are infected, but rather you had a little skin breakdown and what you are seeing is a normal scab that forms in response to the injury.  This is not an uncommon occurrence with a full breast lift, particularly in the area that you have shown.   The increased redness around your wound is a normal response (inflammation) to the skin breakdown as the inflammation brings in cells to repair the wound.  The inflammation also causes redness around the wound site which can often be mistaken as an infection.  Follow-up with your plastic surgeon to confirm that this is nothing more than a superficial wound.  Best Wishes for a rapid recovery!!!!!

Louis DeLuca, MD
Palm Beach Plastic Surgeon
5.0 out of 5 stars 31 reviews

Breast Lift Infection?

+2

Thank you for the question.

It would be in your best interest to follow-up with your plastic surgeon for direct examination. You should have some peace of mind however that most likely you are not dealing with an infection but with superficial  wound healing problems  at the junction of the vertical and horizontal incisions. This is the area where blood flow is the most compromised and tension along the incision lines the greatest.

Every surgeons'  recommendations may differ but I like to use non-stick dressings changed once a day covered by sterile dressings to keep the area clean and dry. If there are no implants in place my level of concern is much less than if implants are present.

Please keep in mind the direct examination by your surgeon is your best course of action.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 682 reviews

Skin loss after breast lift

+2

Thank you for your question and photos. Although it is impossible to tell from photographs alone, it does not appear that your incisions are infected. You have some breakdown of the skin along the vertical incision and at the confluence of incisions. This occasionally happens with full breast lifts and, more commonly, with breast reductions. This is because this area has the poorest blood supply but the greatest tension. For these reasons, some of the skin does not survive and sloughs off. An actual infection is generally associated with increasing pain, swelling, tenderness and possibly fevers and chills.  If you are not having any of these symptoms, you probably do not have an infection. Your surgeon should instruct you on local care to the area.  Do not use dressings that seal the area closed. It is generally best to use an open absorbent gauze and change it frequently.  This should heal on its own.  The scars will eventually settle down and could be revised in the future if necessary.

James McMahan, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 11 reviews

Secondary healing

+1

It looks as though you had some wound separation and areas that have delayed healing. Keep a close eye on them and do the wound care instructed by your surgeon. Follow closely with your surgeon. Often this heals with conservative care and does not usually need further surgery.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 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.