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

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!

This is not an uncommon occurrence when it comes to Breast Lift incisions. I would seek medical attention for that right away. In some circumstances if the opening is small and the breast is not presenting so much redness around the area, you would be able to get away with some bacitracin and a band-aid. When looking at these photos, you are definitely in need of an antibiotic or a Negative Pressure seal to keep that from getting worse.

Open wounds are common after anchor pattern breast lifts. The typical area that struggles the most is at the inferior T-junction. This appears to be the exact location of your wounds. The reason for this is that that zone is stressed the most with the required incisions and tense closure. Other factors can be smoking related but it can happen even in the heathiest individuals. The good news is that it eventually heals. Keep in contact with your surgeon who can guide you through the appropriate wound care. Once it has healed and the scar has evolved for 6 or so months, you can undergo a scar revision.

Incision healing is complicated with Breast Lift. Sometimes there will be wound healing challenges where the incisions meet in the middle and at the crease along that incision. Three weeks out, whatever might be destined to not heal will reveal itself. It is hard to tell from the photos whether there is infection because the lighting is ? If there is redness, tenderness and drainage it is likely the wound is infected. If there is no drainage and just the white tissue that demonstrates compromised healing, but with medical care will do well. Typically the white tissue will be cleaned off to allow the pink tissue to heal and come together, typically with daily washing and application of a topical ointment - vaseline, aquaphor, medihoney or an antibiotic. If you cannot access your surgeon an Urgent Care of ER would be the best option.Best of luck to you!

It’s hard to know if your
wound is infected or if the redness that you note is related to inflammation
that is frequently associated with the healing process.This differentiation is extremely important
and cannot be made without a physical examination or a more detailed
history.It’s not unusual for patients to have wound healing problems
following keyhole mastopexies.The
problem typically occurs where the vertical incision meets the transverse
incision.This location is at risk for
wound separation for a variety of reasons.These include poor blood supply to the skin flaps in this location, the
downward force of the breast tissue against the closure, and high levels of
bacteria that occur in the area of the inframammary fold.All of these factors can contribute
significantly to wound breakdown in this area.Once wound breakdown has occurred, wounds tend to heal by
a process known as secondary intention.As the wound heals, there’s usually an intense inflammatory response
that can make the wound look red and angry.The appearance of a wound healing by secondary intention can often be
confused with infection.For these reasons, these wounds should be monitored
closely.If infection appears,
antibiotics should be started immediately.In the interim, local wound care should be continued with dressing
changes.When this approach is taken,
wounds tend to heal nicely.Rarely scar
revision may be necessary as a secondary procedure.

Thank you for the photo. What you are experiencing is not uncommon with breast lifts and reductions. The area is on tension, and that may effect wound healing. There may also be a spitting suture or some other issue. Please continue to be seen by your board certified plastic surgeon, and tell him/her your concerns. Together, you should be able to come up with a plan.

It is difficult to determine what the diagnosis may be without properly examining a patient. The only way to know is to have a physical examination with a surgeon. It is normal to have some spotting of blood the first week, however, it is completely abnormal to have any drainage after surgery. Leakage of pus coloring along with pain and inflammation can be a sign of infection. Cultures ordered by your physician can determine whether or not you have an infection. It is crucial that you contact your surgeon immediately and inform him/her of your issue so that treatment could be started immediately. I hope this has helped.

please see your surgeon as soon as possible for recommendations on how to treat this and make sure it gets better.

You definitely have issue with circulation in this area with tissue necrosis.  This can  be taken care of with local wound care which will allow this to heal although more slowly.  Contact your surgeon he  needs to instruct you on proper care and make certain that you are heading in the right direction.

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.