Open Wound Increasing in Size Following Mastopexy/augment 6wks Post Op? (photo)

Please help. I wrote in several days ago with question in regards to large open wound 6wks post op mastopexy/augment. I told you that my PS was not concerned and said it WILL heal. My concern is that the wound is increasing in size and not even getting remotely better. He said he forgot to tell me that it will get WORSE before it gets better. Is this true ? Do you advise your patients to keep bacitracin and pad covering or just cover with pad and no ointment ?

Doctor Answers (7)

Open wound post augmentation

+1

The area that has opened up is the area with the most fragile blood supply, hence the wound breakdown. At this stage your care is exactly what I would offer my patients. Topical ointment (like bactroban) and a non adherent dressing.

The wound will likely take a few more weeks to heal, as long as there is no dead tissue left. After which if you are not happy with the widened scar, your PS can offer you a scar revision.

I would only intervene surgically if:

  • there was dead tissue that needed debridement
  • implant was on show
  • wound was so large that it needed a skin graft

Looking at your photos none of these exist, so non-surgical treatment is the best.

 


Sydney Plastic Surgeon
5.0 out of 5 stars 45 reviews

Superficial wounds after surgery

+1

invariably heal with TLC and yours should as well.  The wound has to slough off all the 'dead' tissue before it can heal and that is why it can get bigger before it gets smaller.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 17 reviews

Open Wound Increasing in Size Following Mastopexy/augment 6wks Post Op?

+1

If you are so concerned that your surgeon is not offering you correct care, THAN obtain IN PERSON second opinion. But in my opinion the care being rendered is excellent 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

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Mastopexy Wound Dehiscence

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Your surgeon is absolutely correct in telling you your wound eventually close by itself. The primary problem is to prevent a bacterial superinfection of the open wound which you are doing with the ointment and dressing changes. The other problem is that the new implant is probably causing pressure on the incision making it harder to close. It is probably needless to say that smoking, even secondary smoke, can cause and/or exacerbate the problem. I would recommend a bra that supports the breast implant so to decrease the tension during healing. It will probably take at least two more weeks to close; the eventual scar may need to be revised.

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Antibiotic ointment avoid the adherence of the clean gauze to the new growing tissue  . This incisional wounds start closing from the edges to the center , in a circular advance , little by little  , millimeter to millimeter every day it will go smaller . The pictures show a healthy tissue , soon you will have a completely healed wound and be able to enjoy your full results . 

best wishes,  

Katherine Feliz Camilo, MD
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Open Wound after Breast Surgery?

+1

Your concerns are understandable but I think you are doing the right thing by  continuing with the dressing changes and following up with your plastic surgeon.  I think that what you have been told is correct, and that sometimes these areas of superficial separations “get worse, before they get better”. At 6 weeks, I have found that these open areas and tend to "stabilize” and tend to  heal over the course of the next few weeks.

 Again, continued patience and close follow-up with your plastic surgeon are important. Follow his instructions in regards to dressing changes.

 Best wishes.

Tom J. Pousti, MD, FACS
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Open Wound Increasing in Size Following Mastopexy/augment 6wks Post Op

+1

This looks better to me, and not necessarily larger--the more recent photo is closer in the the earlier one. 

Open wounds do better in a moist environment, so I would prefer antibiotic ointment to a dry dressing. 

The overwhelming majority of these wound separations at the T intersections in breast lifts and reductions do not require surgical closure and heal well with dressings only. Do continue to follow closely with your surgeon. Best wishes. 

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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.