Hello, My wife had a breast augmentation 17 days ago. At her one week appointment, the PS replaced the steri-strips. Her left breast is still quite open. The emergency PS took a look at these pictures and said she has a stitch infection. We felt like the PS didn't appropriately address these concerns at her 1 week appt - could we get a 2nd opinion on the abcess and advise on if this could have been avoided by more care at the 1 week appt?
Concerns with 'Stitch Infection' After Breast Augmentation
Doctor Answers (9)
Breast augmentation complications
Based on the picture you provided it looks like more than the breast augmentation was performed (? mastopexy also). Most likely, your wife's incisional opening is related to a “stitch abscess”. I do not think there was necessarily anything done incorrectly at the one-week postop visit. I suggest continued follow-up with your surgeon. These types of superficial wounds generally heal well over the course of a few weeks.
I agree with colleagues in that most likely things looked fine one week ago, as it takes time for even infections to develop. It is not uncommon to develop these superficial infections or "stitch abscess," etc. The most important thing is that the wound is adequate cared for, i.e. washed out, any residual infection removed, and careful observation along with antibiotics. You wany to make sure the infection is care for, is not delayed, and doesn't progress. Usually, these heal very well, and if necessary down the road, the resultant scars (if any) can be revised within a few minutes under local anesthesia.
What did the wound look like at 1 week?
all depends on the aspect of the wound at the 1 week check-up. It is possible that at that time no signs of infection were present.
Normally, with proper wound care and antibiotics from now, this would should close without any problem.
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Superficial wound infection after a PA incision breast augmentation
It appears that you have a suture knot that has become infected and worked its way to the surface. The suture needs to be removed. Once removed the area will heal normally. Hopefully the deeper tissues are not involved. The only real problem that could occur is if the implant gets infected. Proper wound care should get it healed up.
Infection following augmentation
Infection following breast augmentation should be rare. If it occurs, even in the wound, I believe it should be treated aggressively. This would most likely not show up at your one month post op visit.
Usually stitich abscess develop several weeks to months after surgery and commonly heal on their own without much intervention besides local wound care. Keep a close eye on it with your doctor.
Without knowing more details of the surgery or seeing your wife in person, it is impossible to give specific advice. Also, it does appear that more than just breast augmentation was performed since the incision goes all the way around the areola. This is the incision for a circumareolar lift which can be combined with a breast augmentation. With this type of lift, there is extra stress on the incision when compared to a traditional lift. Regardless, it appears that she has a small wound separation which may have been caused by a stitch abscess. This is just a superficial inflammation and is much different than a true "abscess" in the deeper tissues. The rest of the breast appears healthy with on overwhelming infection, so you should expect the area to heal quite nicely with some localized wound care.
Infection After Breast Augmentation
Based on the photo, it appears that some type of breast lift was also done. It is possible to have superficial breakdown of the incision around the areola (which is what appears to have happened in photo) either from a stitch infection or boarderline circulation to the areola. Both are known and accepted risks of the combined breast augmentation and lift procedure. The only treatment is local wound care and antibiotics if there is any evidence of soft tissue infection. I do not see anything that has been done improperly by her plastic surgeon. It will likely heal without any serious problems.
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