I am 12 days post op, has a prophylactic bilateral mastectomy with insertion of tissue expanders. Drains still in (2, 1 on each side). Right now plastic surgeon asked to clean with hot water using cotton in the mornings, applying polysporin and changing the dressing. This was yesterday and next appointment is on Tuesday. Photo shows right breast although left breast is in the same condition. I appreciate your advice.
Will I need revision surgery, or will I heal on my own? (photo)
Doctor Answers (4)
Please be seen and examined by your surgeon!
Will I need revision surgery, or will I heal on my own?
Appears to be skin edge necrosis due to poor vascular supply to flap edges. The issue is one of expander exposure...
Wound complication following breast reconstruction
Although difficult to assess your wound by photo alone, it does appear that you have a wound of the area. At about 2 weeks postoperative, your surgeon may be waiting for this wound to fully demarcate before making a decision of what to do - continued local wound care or surgical debridement of necrotic skin/tissue. I am certain that your surgeon will discuss the options upon examination in person of the wound and make a decision of which path to take at that time. Certainly, if necrotic tissue is present, it certainly could cause infections; with a prosthetic and maybe dermal matrix beneath the skin flaps, these may become threatened if an infection ensues.
Thank you for the question - hope that this helps!
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Breast reconstruction may require a revision
The picture you show does seem to show necrosis however pictures never replace an in-person assessment. Whether or not this is necrosis, there is nothing you can do to improve your outcome between now and Tuesday. Your plastic surgeon will see you on Tuesday and hopefully by then if there was any doubt about the prognosis for this reconstruction it will be clarified.
If you do need a revision you may have to have some fluid removed from your tissue expander to collapse it and allow the healthy skin to close as the suspicious looking area may require debridement.
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