Open wounds at T section and around nipple from breast reduction. Do these look normal? What else can I do? (photos)

Question

Since my breast reduction I've had a small opening go into a bigger opening within a week. My Dr. Said in the first pic it was normal an to use neosporin and gauze to help heal... but since then(1 week second pic) its gotten worse looking in my opinion. Will i have a huge gap scar?? What does this mean??? Also around my nipple it looks like where my stitches were are the most irritated. Will this heal ugly???

Joshua Cooper, MD, FACS · Answer

Occasionally, breast reduction patients will develop areas of delayed wound healing where a vertical and horizontal incision meet, just like what you have pictured. When this occurs, I recommend patients apply Bacitracin ointment and non-stick gauze to the area, and change it daily. Wounds like this like to be kept moist, as this promotes healing.  I follow these small wounds closely, taking a look each week or so too.Surprising to most breast reductions is that even with a wound like you have, you'll likely go on to heal up just fine in a couple weeks. And, usually the scar ends up looking acceptable as well. If the scar is too wide 6 months or so down the road, your plastic surgeon can always revise the scar using a local anesthetic in his/her office. Thanks for sharing!

Tom J. Pousti, MD · Answer

I'm sorry to hear about the complication you have experienced; Although understandably distressing to patients, these types of incision line healing problems tend to heal over the course of several weeks. Sometimes, the area may look worse before it looks better. Most often, even larger open wounds have healed by the time a patient reached the two months post op mark.
These wounds go on to heal through a process of contraction where the tissues heal from the sides towards the center of the wound; occasionally, removal of unhealthy tissue (debridement) and/or removal of exposed sutures, may expedite the healing process. Close followup with your plastic surgeon will be important; treatment regimens will vary from one practice to another.  Sometimes removal of a exposed suture and/or removal of any unhealthy tissue will expedite healing.  Also important to concentrate on a healthy diet, including good protein source.
 
Best wishes; despite the incision line healing problem it is most likely that you will be pleased with the longer-term outcome of the procedure.

Shareef Jandali, MD · Answer

Good afternoon,One of the risks of undergoing a breast reduction is wound healing complications which it appears you are experiencing. The incisions on the lower part of the breast (T junction) have repeatedly been noted to be the most likely to experience difficulty healing for a number of reasons. While it is going to take a number of dressing changes and time, know that these wounds will heal! In terms of specific wound care, it is best to follow up with your surgeon since they know your surgical sites best. It is also important to rule out that you don't have an infection in this area causing the incisions to open.  Sometimes wounds will change in size/shape as they are declaring themselves. It is important to keep the area clean (shower daily and no hot tubs/pools/baths), provide optimal wound care, and avoid sweating/rubbing/pulling/rubbing to these areas as they heal. Additional things that go hand in hand with wound healing are: no smoking/nicotine exposure and maintaining a healthy diet.  The most important thing at this time is to get the incisions to heal. Once this occurs, if the scars are wide there are options such as silicone sheeting, scar revision, lasering etc. Best of luck!

Robert Applebaum, MD · Answer

Healing problems after breast reduction can occur at this location as it is the one place of tension where the skin edges come together.  I will eventually heal in a few weeks time and the discoloration and scarring with be acceptable in most cases.  I would be in contact with your surgeon to discuss options for dressing changes that will help move the process along. The nipple area will take some time as well to heal and calm down.  Make sure your surgeon is aware of your progress.

Leonard Tachmes, MD · Answer

Hi and welcome to our forum!
The operative procedure of breast reduction involves
separation of the skin and soft tissues of the breast from underlying breast
tissue. Segments of breast tissue are removed, and the skin and soft tissue is then advanced downward and the excess skin
and soft tissue is removed in an inverted "T" fashion.  
If there is impairment of the blood supply to the breast skin and
soft tissue, the segment of the flap the greatest distance from its blood
supply may not survive (at the junction of the inverted "T" flaps).
The cause of the blood supply impairment can range from effects
of smoking, diabetes mellitus, vascular disease, previous surgery in the
area (disrupting the normal blood supply), infection, or may totally
inapparent.  
Treatment consists of removal of the unhealthy tissue, followed by
intensive wound care. One looks for the development of granulation tissue, a beefy
red vascular tissue, to develop, after which time the wound will begin to
shrink. Most wounds of this size will seal over a span of 8-12 weeks.
However, a regimen of frequent wound care is required after unhealthy
tissue is removed. 
Your wound is relatively clean and is granulating. Follow your plastic surgeon's instructions. Once, the wound contracts and seals, allow the scar to mature before considering revision as many resulting scars heal remarkably well. 
Best wishes...

Open wounds at T section and around nipple from breast reduction. Do these look normal? What else can I do? (photos)

Answers (5)

Answer: Open wound at the T site

Answer: Open wound at the T site

Answer: Delayed healing after breast reduction

Answer: Delayed healing after breast reduction

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Everything you need to know about Breast Reduction

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Open wounds at T section and around nipple from breast reduction. Do these look normal? What else can I do? (photos)

Answers (5)

Answer: Open wound at the T site

Answer: Open wound at the T site

Answer: Delayed healing after breast reduction

Answer: Delayed healing after breast reduction

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Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.