Wound Separation After Stitches Removed? (photo)

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.These wounds form a layer of granulation tissue and eventually the skin
grows over the top of this layer. As the
wound heals, there’s usually an intense inflammatory response that can make the
wound look red and angry.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.It’s important that you maintain close contact with your
plastic surgeon.Your plastic surgeon
can answer all of your questions and help you get through this very difficult
experience.

With
the Wise pattern, the T-shaped incision frequently dehisces.  You are an example of what to expect with
this technique.  For this reason, I have
not used the Wise pattern for over twenty years.  The technique I recommend is The Bellesoma
Method, which avoids T incisions.  Your treatment
is wound care, debridement and possible scar revision.Best Wishes,Gary Horndeski, M.D.

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. Suture or steri-strips is not what is needed at this point.  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.

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 antibacterial ointment.  Wash hands prior to application. It will heal in 3-8 weeks and it will hardly be noticeable. If it is, then your surgeon can perform a small scar revision in 6 months. I would not recommend re-suturing the areas.  Please discuss your concerns and follow closely with your Plastic Surgeon.

   Wound separation is one of the most common issues in a full breast lift, particularly at the T-junction.  Usually this area heals very well.  The openings continue to contract and the scars lighten over the course of a year.