Scars not healing and stitches opening, 7 weeks post breast lift, what should I do? (photos)

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

I usually tell my patients not to put any ointments or tape over the incisions just to keep it dry and it will heal soon, but every surgeon has different post op instructions continue to follow up with your PS.

Dear vgranado78,this type of wound is not uncommon after breast lift. It is usually caused by poor blood flow or stitches. I would suggest you to consult your plastic surgeon, follow your surgeon's instructions and keep your wound clean and covered. It can take few weeks for wound to fully heal. Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

It looks like your having some wound issues probably due to dissolvable stitches, This will settle but best to keep in contact with your PS for advice re dressings / massage and scar management.

Thanks for the photos and question. While your surgeon has given you reassurance - which is nice to hear - I am always a bit worried about patients who have pinholes or delayed healing after implants. If no implants were used in your breast lift, I would be less concerned, as it is the risk to the foreign body being exposed or becoming infected that informs most of our concern when incisions look like this on the breast. Sometimes these holes are the result of dissolvable sutures becoming inflamed/infected or otherwise trying to work their way out. However, if you have an implant at the base of the hole, there is a concern about the implant being "exposed" to the outside world (even if you can't actually see the implant through the hole).  I usually don't advise my patients to use silicone gel, vitamin E, or other SCAR management techniques until the WOUND is closed. Make sure you have regular followup with the surgeon.

Some separation of the incision in this area is not a rare occurrence and this should ultimately heal. Without knowing your medical history, it is not clear if there is another healing issue going on as well that needs to be addressed. Discuss with your surgeon what he/she recommends for local wound care and have him/her check the wounds for possible deep sutures. Ultimately, you may require a scar revision of this area.Steven Turkeltaub, MD