I'm not a native english-spoken so sorry in advance for my writting. I had a breast reduction with implants and tummy tuck 5 weeks ago. Everything seems to be perfect but since 1 week ago I start spitting stitches and there's some small holes now. Today I saw my PS and told me That this areas need Debridement and be suture again so make the healing fast. I'm on antibiotics now. So this "cleaning" and closing is a good idea?
Is a Good Option the Debridement and Suture? (photo)
Doctor Answers 7
Mommy makeover - post op debridement
Hi, I would remove any sutures that are coming to the surface of the skin. I then would clean up any tissue that need to be trimmed off however I would not recommend stitching at this time. After you have completely healed, I would have you come into the office to see what scars need a revision. Best wishes!!
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Healing problems after a breast reudction
Wound separation and marginal ischemia are not normal but are also not uncommon. You should be evaluated by your plastic surgeon, debrided as needed and placed on a wound protocol to avoid problems while healing. If there are exposed sutures then these need to be removed.
Breast Lift and Implants Suture Spitting
Breast lift and implants surgery patients may have suture spitting which can be remedied by local wound care and suture removal. In the absence of infection, this is appropriate management.
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Cleaning and re-suture?
Hello and thanks for sharing. All the photos you have shown appear to indeed demonstrate suture spitting. What your PS has offered seems a reasonable approach. Perhaps some areas will respond with more conservative management. Keep in close contact with your PS. Hope this helps - Dr. Aldo.
Debridement and Suture?
Of the three photos, the only one that is of some concern is the "t" incision line. The photo is not too well oriented and I can't quite get a feel for what is going on, but I would not quarrel with a recommendation for debridement, Closure decision would be based upon findings, but chances are I would just debride.
The other two areas appear to represent spitting sutures, and I would just remove the sutures and trim any non-viable tissue in the office.
Your surgeon who has seen you in person has quite the edge over online evaluators, and I would yield to his opinion and recommendations.
Many of the native English speakers and writers who ask and answer questions on this site should write as well and clearly as you.
Spitting sutures is treated differently than necrotic tissue
Thank you for the question and photos. There is no right or wrong way to deal with this. The sutures if left alone will eventually dissolve and the extrusion (spitting) process will stop. If the tissue is removed and resutured it will be important to use Monocryl as I suspect most of the suture spitting issue you are having is Vicryl.
All the best,
Dr Remus Repta
Incision Line Problems after Breast Reduction and Tummy Tuck?
Thank you for the question and pictures.
In the field of plastic surgery, there are often many ways to address the same “problem”. Ultimately, it becomes a clinical judgment by your plastic surgeon ( after a discussion of pros/cons with you) what the best course of action may be. For example, there are areas on your pictures that I would allow to heal without surgical intervention at this time.
On the other hand, I am concerned about the appearance of the breast reduction incision line; this is especially concerning given that you have breast implants in place. It will be very important to avoid contamination and/or exposure of the breast implants.
The most important factor to a successful outcome, in my opinion, is close follow-up with your plastic surgeon. Again, discuss any concerns about recommendations that he makes; you should be aware of the pros/cons of any available options.