Is it better lo leave the scab alone (and dry) or try to make it fall? (photo)

I have a thick scab over my right nipple due to necrosis. I had bl with implant done in Colombia on Oct 29, 2013, my right nipple turned black (necrotic) and now 1 month after the surgery I still have a thick scab over. Is it better lo leave the scar alone (and dry) or try to make it fall? I read on Google that a good way to loosen it up was to apply a water base paste of baking soda and it did soften the scab but the sides now look gooey and the skin underneath is very red/pink. I want to speed healing, I am desperate!!!

Doctor Answers (8)

Scab after breast surgery

+2

Small scabs are definitely better off when left alone. Pulling off a scab can worsen the final scar in many cases since the environment under the scab stays sterile, moist for growing cells, and protected from the outside world.

For larger scabs like yours, it is sometimes better to have a physician remove the scab surgically and treat the wound with dressings to speed up healing. It's not skin you see under a scab that large but tissue called "granulation tissue" that will eventually become covered with skin that will grow in from the edges. Areas where there are scabs as large as yours usually heal with thin skin and worse looking scars than the incisions around it. This can be revised in the future once the tissues soften up (6-12 months after healing). I advise you to make an appointment with a board certified plastic surgeon in your area for evaluation so you can sure you are doing everything you can to optimize your outcome.


Jupiter Plastic Surgeon
5.0 out of 5 stars 11 reviews

BBA

+1
You need to see a local PS in your area.  You risk exposing the implant if you remove the scab.  Please see a PS ASAP.

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast Enhancement Surgery

+1
I agree you should see a local surgeon, I sometimes remove these as they are basically hanging on and dont do what they are supposed to do and act like a "medical dressing that is sterile"

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
5.0 out of 5 stars 39 reviews

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Scab post lift

+1

I would see a plastic surgeon.You want to prevent infection which could cause you to lose your implant.This is one of the many problems that can arise from going overseas to get plastic surgery.If a complication arises you have a long way to go to get help.think twice about it in the future.

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Partial necrosis of areola/nipple

+1

You really need to see a surgeon to help manage your complication. Generally, we would allow the dark area to fall off on it's own, but you need to seek professional advice immediately.

Shim Ching, MD
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Complications following surgery abroad

+1

need to be managed by a local surgeon who can help you with wound care and other issues should they develop. If your implants are over the muscle, you could be facing exposure of your implant when that scab falls off. If you can contact your surgeon via the Internet and are comfortable sharing your photos on-line, your surgeon could provide you with wound care instructions.

Curtis Wong, MD
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Is it better lo leave the scab alone (and dry) or try to make it fall?

+1

It is the option for your surgeon to decide. In my practice I tend to remove necrotic tissue as it demarcates.

Darryl J. Blinski, MD
Miami Plastic Surgeon
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You need medical care

+1

This is full thickness tissue loss. I assume you cannot return to Columbia for followup so you should see a board certified plastic surgeon ASAP for supervised wound care. You are at high risk for an infection around the implant which will necessitate its removal.

Barry Press, MD
San Jose Plastic Surgeon

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.