i had a breast uplift and implants 3 weeks and a half ago, everything was fine until last week my left breast's stiches opened i went to my GP, they changed the dressing, i kept it always clean and now it has a white secretion even under the stiches in the areola and now the right one is deteriorating too, my surgeon, who is abroad, said i should let it heal and scar then he would fix my scar but im worried my implants might be infected, they put me on antibiotics and changed my dressing.
Is my Implant Infected?
Doctor Answers (9)
Breast Augmentation / Lift Complication - wound separation with Possible Infected Implants
Regarding: "Is my Implant Infected?
i had a breast uplift and implants 3 weeks and a half ago, everything was fine until last week my left breast's stiches opened i went to my GP, they changed the dressing, i kept it always clean and now it has a white secretion even under the stiches in the areola and now the right one is deteriorating too, my surgeon, who is abroad, said i should let it heal and scar then he would fix my scar but im worried my implants might be infected, they put me on antibiotics and changed my dressing."
Dear TiaM, I am really sorry for what you are going through.
A few comments. I realize the British medical system is different than that in the USA but it strikes me as fundamentally wrong that a GP is managing a Plastic Surgery patient.
A Plastic surgeon should be following a Plastic surgery patient because only he/she understands the complexities of what we do and the consequences of our actions. This does NOT mean that your Plastic surgeon should be chained to your side and not be able to have a life but in the US we always arrange for another Plastic surgeon to cover our patients when we leave town. It is only proper. You paid for and deserve the best of care.
Your photograph is blurry but it clearly demonstrates a wide separation of the vertical limb of the breast lift (Wound Dehiscence ?Left breast) with obvious dead tissue and exposed stitches. Such wounds need to be treated aggressively and have all the dead tissue removed; not doing so will result in the dead tissue serving of a source (IE NIDUS) of bacteria and on-going seeding of the blood with these bacteria. Removal of the dead tissue may be done at the bedside or may require one or more trips to the operating room. This is a surgical decision that only years of experience impart and which your GP most assuredly lacks.
There is an outside, remote chance that the implants are not infected. It is more likely that they probably are. The odds of saving infected, exposed implants is extremely small and they would probably have to be removed.
As to what caused this, your surgeon would be the best to guess. It APPEARS your implants are large (and are putting tension on the vertical closure) and that the incision was under tension. If you are a smoker or interact with smokers that would have been the nail in the coffin. Same goes for a tight skin closure in certain disorders associated with deceased blood supply.
I would strongly advise you to ditch the GP and seek out a respected, REAL FRCS Plastic surgeon. Such a physician is your best shot at getting the best outcome from this sad situation and if you smoke - PLEASE stop.
Dr. Peter Aldea
Incision problems should be addressed immediately.
You should go back to a Plastic Surgeon in your area and show them the incision you are having trouble with. Changing the dressings may not be enough. It is better to be safe than sorry.
Wound breakdown and implants
It looks like some of the skin along the vertical limb has necrosed. You may have impending implant exposure if you do not have al ot of soft tissue covering the implant. Sometimes the implant has to be remove and then replaced at a later time after the tissues have healed. Follow closely with your doctor. Good luck!
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Yikes! Get thee to a real plastic surgeon ASAP. This looks really bad and needs expert care. If your implant isn't infected already, it will be soon unless this external infection gets under control. No GP in the world (even Marcus Welby) knows how to handle this.
Lisa Lynn Sowder, M.D.
Breast Lift Complication
What your photo demonstrates is a breakdown of the vertical limb of your augmentation mastopexy procedure and an impending exposure of the implant. Essentially, the skin closure was too tight resulting in death of the skin and fat. The indication that you are draining fluid is concerning as well. I do not feel that this is an issue your GP should be taking care of. You need to see a Plastic Surgeon in London. Without appropriate care, this may very well lead to exposure of the implant necessitating removal. From this blurry photo, one cannot say that the implant is truly infected, however, it would be surprising if it doesn't become so shortly. Please seek an appropriate consultation with a Plastic Surgeon soon.
The Epic Battle of Breast Augmentation plus a Breast Lift
It appears that you have had a wound healing issue meaning that an implant was placed and lift perform and closing the skin at that site was very tight. This the great battle in augmentation plus mastopexy, where an implant is placed to make the breast fuller but a lift is also performed to tighten the breast which makes it smaller.
I would recommend continued dressing changes to get the wound to health. After the wound is healthy then it may be allowed to heal to completion or have a skin graft placed. You will know if the implant is infected because the entire breast will become sore and red.
Lastly, your GP is gracious to help you with this but you need a plastic surgeon to see you through this. Preferably the PS who operated on you! This is the issue with traveling abroad to get surgery because if a complication occurs the situation becomes a slippery slope.
Infected implants after breast augmentation and lift
Wound dehiscence is a possible complication of breast augmentation with lift, and there is a higher risk of this occurring when there is tension on the incision, or where the circulation is compromised as in diabetics and smokers. Infection may be present as well, but determining this requires physical examination and cannot be accurately diagnosed from a photograph. Your plastic surgeon is the best person to assess and manage this type of problem, and if unavailable you would best be suited seeking help from another plastic surgeon who is experienced in treating these problems.
You need to see a Board certified plastic surgeon
You are in a difficult situation and your plastic surgeon should be taking care of you. Your surgeon would know the thickness of the tissue,risk of the implant exposure and the best treatment plan. You need to find a plastic surgeon that would take care of you before the wound gets bigger.
Agree fully with Dr. Aldea
Dr. Aldea composed a very well-reasoned reply to your question, and I fully agree with his assessment and recommendation. There is no scenario I can imagine in which it is appropriate for a GP to manage a postoperative wound, particularly one involving an implant.
Your photos also appear to show impending breakdown of skin around your areola (the two black spots I see in your photo in the incision around your areola). You need aggressive, immediate wound management by a plastic surgeon who deals with breast implants often.
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.