Is This Normal? What Do I Do if my Plastic Surgeon Won't Help Me? (photo)

I am 38 years old and undergone a breast augmentation (due to back problems) on January 15, 2012. The next day my left breast had split open about the size of a dime. I called the surgeons office and was told by the dr. & his nurse that it is normal but probably caused due to me smoking 1-2 cigs a day. The pain is terrible, what should I do ?

Doctor Answers (11)

Wound healing problems after breast reduction

+1

Hello,

Thank you for the photos.  It appears that you have wound healing problems after a breast reduction or breast lift.  Many factors combine to contribute to wound healing problems.  It is true that tobacco use can hurt the healing process.  At this time you may benefit from debridement of non viable tissue, further reduction of breast size, and either partial closure or full closure of wounds over a drain.  Discuss these with your plastic surgeon as prolonged open wounds are obviously painful and cumbersome.

All the best,

Dr Remus Repta


Scottsdale Plastic Surgeon
5.0 out of 5 stars 81 reviews

Wound healing problem after breast surgery

+1

Your photos resemble a breast reduction or lift rather than an augmentation.  It is certainly true that smoking can result in wound healing problems.  The real issue here is that you need immediate attention to help you heal.  Have you sent these pictures to your surgeon? If you really do have an implant, it should be removed.  You could benefit from hyperbaric oxygen, local wound care, and more surgery to remove dead tissue.  Tissue cultures would also be useful in case you have an infection. 

Bruce Genter, MD
Abington Plastic Surgeon
4.0 out of 5 stars 11 reviews

Wound breakdown following surgery

+1

I am sorry you are having this problem. Smoking can certainly cause wound breakdown after surgery. I am not sure how a breast augmentation will cure back problems. You must have a wonderful insurance policy!

Nevertheless you now need continuous and well-supervised care from your plastic(?) surgeon. He/she should be seeing you at least twice per week to orchestrate your dressings and wound care. He/she should be debriding any dead tissue at each visit and sending wound swabs for culture and sensitivities. Antibiotics may well be indicated and you may even need to be admitted to hospital. Certainly, any implants will need to be removed.

Later on, skin grafting, delayed closure and scar revisions are on the cards.

The problem with many 'chop shops' and 'doc in a box' operations is that they are not set up to manage complications such as this. If you are not the treatment you need, go and see a Board Certified Plastic Surgeon at once.

And, no, it is not normal.

J. Brian Boyd, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 3 reviews

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Is this normal?

+1

This is a difficult problem and I am sorry you are having to go through this. None of us like to see things like this. Being that said your pictures are more consistent with a reduction, breast lift or breast lift with an implant not a breast augmentation as you describe. Smoking increases wound healing complications up to 12 times more than non-smokers and that is very explicit in the medical literature. Being that said, quitting will help you heal much better. The picture that you show at 5 months out seems to me to still be pretty big. I do not think any surgeon in this forum would turn their patient down if this happened to them, so if yours is denying you then just seek another opinion. If you were my patient at this point I would likely offer placement of a skin graft. Covering the raw surface with skin can reduce your discomfort remarkably. Since non of us can really appreciate this without seeing it we have all seen similar wounds at some point in our careers as residents or in practice. This needs to be cleaned up most likely and whether or not your surgeon feels continued dressing changes or coverage with a graft is up to their expertise. Make sure you go see your surgeon ASAP so they can help you. Best of luck!

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 14 reviews

Is This Normal? What Do I Do if my Plastic Surgeon Won't Help Me? (photo)

+1

Your story and posted photos are impressive to say the least! Seek immediate care as in a doctor who will see you at least twice a week. Have any implant removed if there is one. Seek hyperbaric oxygen therapy and possible skin grafting. You need care now! 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Breast reduction and smoking

+1

Smoking increases the risk of complications and this can happen with breast reduction flaps.  Usually conservative management with frequent dressing changes is the treatment if there is not infection.  Follow your surgeons instructions carefully.

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

Wound Healing Problem after Breast Reduction?

+1

I'm sorry to hear about the complication you are experiencing. These types of wound healing problems can occur after breast reduction or lifting surgery. Dressing changes and/or surgical intervention may be necessary;  therefore,  relatively urgent follow-up with your plastic surgeon is indicated. It is very unlikely that he/she will not “help you”. If this is a case, however seeking consultation with another plastic surgeon will become necessary.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 681 reviews

Complicated breast reduction

+1

It appears that you have very significant wound problems with possible infection and loss of fat tissue (fat necrosis) within the wound. Such serious problems require continuous care so see you surgeon right away. If true that he will not see you, you will need another to step in and help you through.

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

Breast Surgery Complication

+1

It appears that you had either a breast reduction or breast lift, not an augmentation.  You have some tissue necrosis present that can be caused by smoking.  Regardless of the cause, you should have your surgeon see you or if not, see another board-certified plastic surgeon for treatment.

Donald Griffin, MD
Nashville Plastic Surgeon
4.0 out of 5 stars 12 reviews

This is not normal

+1
An open wound with prurulence is indication of an infection. You need to be seen in followup as soon as possible. Cigarette smoking placed you at risk for poor wound healing but, now that the situation has arisen, it needs to be addressed. You have written that you had an augmentation but then note back problems so it sounds as though you have had a reduction. Please seek treatment asap!

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 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.