Incision Looks Infected 3 Weeks After Breast Lift- Opinion? (photo)

Hi there, I need some advise on my breast. I had surgery oct 14 th, 2011 (almost 3 weeks ago), My incision doesn't look good, they getting worst. I called Dr. but then they told me that its fine and it heals that way. But I don't know what to think about that? Please help me, this is actually my second surgery, my first was 4 month ago, i wasn't happy with the result because they did areola lift ( that didn't help at all with my saggy breast) Now i had full lift. :(

Doctor Answers 15

Possible breast lift infection?

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I'm sorry you have had to undergo a second operation to achieve the degree of lift you wanted and apparently needed. Your incision does not look infected, but there are incompletely-healed areas that could become infected as they are still open and normal circulation is not yet restored to these areas, which is why they have had difficulty healing thus far. This is not uncommon, and your surgeon needs to not only reassure you, but give advice to keep this from turning into a problem.

Some practical hints: If you are a smoker, or even exposed to second-hand smoke, you MUST discontinue this immediately. As I noted above, the inverted-T area of a Wise-pattern (anchor pattern) mastopexy is the area of least-robust circulation. Because of this the vertical scar actually heals with the finest and least-visible scar, BUT first it must heal. It can't do so without circulation. If you're not smoking or around smokers, or using nicotine patch, spray, gum, etc., good for you. If you are, stop IMMEDIATELY! But this area is still partially open, and susceptible to becoming infected.

Keep these areas clean. If OK with your surgeon, wash gently with soap and water (not hydrogen peroxide), pat dry, and keep a clean gauze dressing on the incisions. I'd advise NO antibiotic ointment, especially triple antibiotic ointment (such as Neosporin or Mycitracin). No ointment at all because chronic use can cause the wound to soften and separate further, and can (with chronic use) even stimulate an allergic reaction, which "looks" like an infection. So you use MORE ointment and it gets worse, not better! (Because it's an allergic reaction, NOT an infection). Triple antibiotic only gives you 3 times the likelihood of stimulating an allergic reaction, so cleanliness is better than gooping-up with antibiotic ointment. No hydrogen peroxide because it not only kills germs, but also inhibits epithelial cell growth and can actually slow healing. The exception can be an actually purulent (pus) wound, but then only once or twice with peroxide until it's clean.

Although it truly does not look infected, the tissues are compromised, which is to say that they are more susceptible to infection than the other areas of your incisions that are nicely intact and further along in their healing. So, while I am stressing that I am NOT recommending oral antibiotics because I think there is an infection here, I would recommend a broad-spectrum antibiotic to MINIMIZE the chances for these areas of incomplete healing to become infected. Just good common sense precaution, IMHO. If implants are involved, this is even more critical, to minimize potential contamination/infection that would require removal.

If fever, chills, or purulent drainage is noted, this should be cultured by your surgeon and appropriately-chosen antibiotic treatment instituted promptly (which might mean a change from the "prophylactic" antibiotic recommend earlier).

Wear a lightly-supportive cotton stretch bra without underwire. Avoid lifting, straining, or activities that might stretch the breast incisions. You are only 3 weeks out from surgery so your incisions are not yet durable, and these even-less-durable areas should be checked at least weekly, or more if needed or if they change.

Although there may be slightly more scarring in these areas, you will be amazed how much better they end up than how you think today they will look when finally healed. So be patient, see your surgeon regularly, and follow his or her advice. Ask about the hints above if they disagree with your doctor's advice. Good luck!

Skin loss after breast lift

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Thank you for your question and photos. Although it is impossible to tell from photographs alone, it does not appear that your incisions are infected. You have some breakdown of the skin along the vertical incision and at the confluence of incisions. This occasionally happens with full breast lifts and, more commonly, with breast reductions. This is because this area has the poorest blood supply but the greatest tension. For these reasons, some of the skin does not survive and sloughs off. An actual infection is generally associated with increasing pain, swelling, tenderness and possibly fevers and chills.  If you are not having any of these symptoms, you probably do not have an infection. Your surgeon should instruct you on local care to the area.  Do not use dressings that seal the area closed. It is generally best to use an open absorbent gauze and change it frequently.  This should heal on its own.  The scars will eventually settle down and could be revised in the future if necessary.

Wound breakdown common with keyhole incision.

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It’s hard to know if your wound is infected or if the redness that you note is related to inflammation that is frequently associated with the healing process.This differentiation is extremely important and cannot be made without a physical examination or a more detailed history.

It’s not unusual for patients to have wound healing problems following keyhole mastopexies.The problem typically occurs where the vertical incision meets the transverse incision.This location is at risk for wound separation for a variety of reasons.These include poor blood supply to the skin flaps in this location, the downward force of the breast tissue against the closure, and high levels of bacteria that occur in the area of the inframammary fold.All of these factors can contribute significantly to wound breakdown in this area.

Once wound breakdown has occurred, wounds tend to heal by a process known as secondary intention.As the wound heals, there’s usually an intense inflammatory response that can make the wound look red and angry.The appearance of a wound healing by secondary intention can often be confused with infection.

For these reasons, these wounds should be monitored closely.If infection appears, antibiotics should be started immediately.In the interim, local wound care should be continued with dressing changes.When this approach is taken, wounds tend to heal nicely.Rarely scar revision may be necessary as a secondary procedure.

Breast lift and wound problems

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Is not uncommon to have problems with wounds after a breast lift. These rules may be due to a decreased blood supply in the flap to tension in the world are to both.

Infection is the thing that you must be concerned with. Watching for drainage, redness or fever would be evidence of infection. Keeping the wound covered with antibiotic ointment may be a good idea. Letting this would heal on its own is the best way to deal with this type of would. Once its healed the scar can be revised to approve its appearance.  Monitor your wound and follow-up frequently with you Dr. to make sure your wound is healing well.

Infected incision

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It looks like your wound has broken down a little bit where there is the most tension, combined with a spitting suture.  It does not look infected overall based on your photo- but you could use some wound care in that area.  I would see your plastic surgeon and have them check for any deep suture that may  need to be removed under the open area.  Make sure your bra is not rubbing on or irritating the area and making things worse.  Good luck!

Skin breakdown after breast lift

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I am sorry to read that you have experienced a complication. Skin surface breakdown with secondary healing can occur after mastopexy. It is impossible to determine whether this is also infected without an examination. Any redness, swelling, prurient drainage or systemic changes such as fever would be indicative of infection. I encourage you to followup regularly with your plastic surgeon and call if these problems develop so they can be treated ASAP. Your surgeon can determine if the wounds need debridement or other treatment and instruct you in postop care. Not to be minimized are risk factors precipitating problems in wound healing including smoking and diabetes, among other things. Best of luck to you. Dr K

Infection in scar from breat lift

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There is some wound break down in the scar and the area is inflamed. This is a relatively common complication. This does not look overtly infected. But if you get any pain, if the area feels hot to touch, if there is a lot of discharge, particularly foul-smelling discharge - please see your surgeon straightway.


Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon

Breast Lift Infection?

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Thank you for the question.

It would be in your best interest to follow-up with your plastic surgeon for direct examination. You should have some peace of mind however that most likely you are not dealing with an infection but with superficial  wound healing problems  at the junction of the vertical and horizontal incisions. This is the area where blood flow is the most compromised and tension along the incision lines the greatest.

Every surgeons'  recommendations may differ but I like to use non-stick dressings changed once a day covered by sterile dressings to keep the area clean and dry. If there are no implants in place my level of concern is much less than if implants are present.

Please keep in mind the direct examination by your surgeon is your best course of action.

Best wishes.

Wound on breast

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You definitely have issue with circulation in this area with tissue necrosis.  This can  be taken care of with local wound care which will allow this to heal although more slowly.  Contact your surgeon he  needs to instruct you on proper care and make certain that you are heading in the right direction.

Incision issue 3 weeks post op

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Thank you for the photo. What you are experiencing is not uncommon with breast lifts and reductions. The area is on tension, and that may effect wound healing. There may also be a spitting suture or some other issue. Please continue to be seen by your board certified plastic surgeon, and tell him/her your concerns. Together, you should be able to come up with a plan.

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.