5 weeks post op a small puss dot about the size of the end of your baby finger appeared. Within one week, it was an inch squared. 7 weeks post op and it has now spread to 3 inches by 2 in the form of a triangle under the breast and half way up to the nipple. The area is bleeding and oozing yellow puss constantly. Surgeon says it's fine and to apply polysporin to it, but with the bleeding and puss, it has not improved.What should I do? My surgeon is not too concerned, should I be?
5 Weeks Post-Op Breast Surgery Have Infection with Bleeding and Puss. Surgeon not Concerned, Should I Be?
Doctor Answers 4
Infection folowing BA
It sounds like you had lifting of your breasts in addition to augmentation. The junction of the horizontal and vertical incisions is a common place for an opening to develop and often there can be clear yellow drainage for a few days. What may look like pus could well be what I describe as a "wet scab". As an open wounds close a pink cobbled surface develops called granulation tissue. It bleeds easily, but stops quickly. This is a good sign and heralds natural closure of the wound with time. It is difficult to close a fresh surgical wound and often allowing the wound to heal and revising the scar later gives a better end result. The enlarging nature of your wound and the persistent drainage are a concern. Is the breast swollen, red and/or tender? Do you have a fever? Is the fluid coming from the breast pocket or oozing from the raw surface of the wound? I would get a culture of the fluid and consider antibiotics. If an infection develops around the implant it will have to be removed for awhile and replaced with a new one after the infection ois treated and the wound closed. Talk to your surgeon again and be assertive in voicing your concerns. You need more re-assurance.
Bleeding and pus after breast surgery--what does this mean?
You did not state what kind of breast surgery you had, or whether implants are involved or not. If you had breast augmentation via a periareolar or inframammary incision, it sounds as if your wound breakdown is large enough to be of concern, but that yellow drainage may not be pus. Without seeing the character and type of exact drainage, you should know that only healthy tissues bleed, and dead or infected tissues do not. Serous drainage (yellow serum identical to blister fluid) can fool many a non-medical person (and even a few non-surgeon physicians) into thinking a wound that drains yellow serum is infected and draining "pus." Even dead fat cells appear yellow when they liquefy and drain, but too much of this is not a good thing either.
It sounds as if you had a breast lift or reduction (or possibly lift plus implants), and wound breakdown (usually from inadequate circulation, or from nicotine vasoconstriction) has occurred. Topical wound care to keep the open area clean and moist is appropriate, and prophylactic (preventive, or "just-in-case") antibiotics are often reasonable but not always necessary if the wound is clean and not infected. Your surgeon has the expertise, not to mention the ability to examine your wound, to tell you what is going on, and you should follow his advice and continue to follow-up. If things change, especially for the worse, and particularly if you have implants (if they become infected they will have to be removed), you should contact your surgeon immediately.
Don't assume your doctor's calm and non-excited demeanor about this means he is "not concerned;" rather he is trying to keep you from overreacting or doing something harmful to your surgical site. Talk to your surgeon!
Bleeding folllowing augmentation
If you have just had an augmentation, this is not normal, but if you have had an uplift as well, it may be alright. It is difficult to give an opinion without seeing you as the oozing yellow pus, may just be some slough or dead tissue that can heal without a problem. If there is frank, thick, yellow pus oozing from your wound and you have implants in, I would be concerned.
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