4 Weeks PO Following BR - Taking Keflex but Open Wound Appears Larger; Infection Symptons Not Resolved, Solution? (photo)

4 wks post op following a BR; began experiencing shooting pains, and pain under left breast and up outer side of the breast. Breast is swollen and tender, incisions are swollen, warm, and red. Also dev. an open wound with dark green discharge. Prescription of Keflex called in. Taken the antibiotics 3 days and applying bacitracin. Open wound appears larger, and the red streaking up the outer side of my breast hasn't resolved. No fever or nausea; still experiencing localized pain and general malaise.

Doctor Answers 8

Three signs you need physician attention after breast reduction

The following signs need urgent attention after breast surgery: purulent drainage (pus), temperature greater than 101,  growing erythema (redness) around the incision. You should have your surgeons look at that black spot as it looks like an area of tissue necrosis. All this is fixable, but it needs aggressive management.

Beverly Hills Plastic Surgeon
4.7 out of 5 stars 16 reviews

Dead tissue after breast reduction may need to be removed.


Cannot be sure, but I think the main problem is not infection.  You may have some tissue without blood supply which requires debridement.  See your surgeon!

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Infected BBR

There is fat necrosis.  It is hard to make out based on the photo but this may need to be debrided/cleaned.  If there is infection brewing under this then you may need some debridement for sure...if there is no signs of infection then this can sometimes be allowed to resolve on its own.  Hard to tell from this photo but looks like this is infected.  Have your surgeon take a look at this again.

Good luck

Dr. Vasisht

Bhupesh Vasisht, MD
Voorhees Plastic Surgeon
5.0 out of 5 stars 87 reviews

Take a deep breath and relax, your wound will heal fine

I would not get too alarmed with this wound. You've got a small area of skin loss in a spot that happens frequently and heals very well cosmetically most of the time. A small debridement (removal) of that dead tissue in your surgeon's office s probably warranted and this should go on to heal fine as the deeper tissue visible looks ok. A topical petroleum product like Aquaphor or topical antibacterial product (like Silvadene) should be applied to facilitate healing and I would just cover the wound with some gauze or a maxipad in your bra to control any drainage. You would not ordinarily need antibiotics or cultures for this type of wound.

Robert Oliver Jr., MD
Birmingham Plastic Surgeon
5.0 out of 5 stars 3 reviews

4 Weeks PO Following BR - Taking Keflex but Open Wound Appears Larger; Infection Symptons Not Resolved, Solution? (photo)

Thank you for your question and the detailed information.  This is a condition that happens in 1-2% of patients after a BR.  It is not something you should worry about, just follow your PS's instructions.  The open wound will heal with invisible scars because the pink surface you see in the open area is actually dermis which will generate new skin.  So, just take your antibiotics, do the dressing changes, and be patient.  The end result will be satisfactory, especially since the rest of your scars have already healed nicely.

Ruben B. Abrams, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 19 reviews

Open wound and signs of infection after breast reduction

It looks and sounds like you need to see your plastic surgeon urgently in follow-up.  With no signs of improvement after 3 days of Keflex, you may need a wound culture, further debridement of non-healing or devitalized tissue, and a change in antibiotic. 

Elizabeth Kim, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 28 reviews

4 Weeks PO Following BR - Taking Keflex but Open Wound Appears Larger; Infection Symptons Not Resolved, Solution?

You need a wound culture done, blood tests, local mechanical debridement... I might recommend red light IPL with PRP infusion to area to speed healing. There is a costs to PRP therapy though. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Unwell post breast reduction

Hello, sorry to hear about your misfortune.

I would think that if you have not improved with oral antibiotics and your wound is getting worse then you should see your plastic surgeon urgently again and you may require to have an admission to hospital for some intravenous antibiotics.  You may also require to have some further surgery to clean the wound and remove some of the dead fatty tissue and skin.


Stephen Salerno


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.