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

Question

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. :(

Richard J. Bruneteau, MD · Answer

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.

Joe Gryskiewicz, MD, FACS · Answer

This is not an uncommon occurrence when it comes to Breast Lift incisions.   I would seek medical attention for that right away.  In some circumstances if the opening is small and the breast is not presenting so much redness around the area, you would be able to get away with some bacitracin and a band-aid.  When looking at these photos, you are definitely in need of an antibiotic or a Negative Pressure seal to keep that from getting worse.

Justin Yovino, MD, FACS · Answer

Open wounds are common after anchor pattern breast lifts. The typical area that struggles the most is at the inferior T-junction. This appears to be the exact location of your wounds. The reason for this is that that zone is stressed the most with the required incisions and tense closure. Other factors can be smoking related but it can happen even in the heathiest individuals. The good news is that it eventually heals. Keep in contact with your surgeon who can guide you through the appropriate wound care. Once it has healed and the scar has evolved for 6 or so months, you can undergo a scar revision.

Michele A. Shermak, MD · Answer

Incision healing is complicated with Breast Lift. Sometimes there will be wound healing challenges where the incisions meet in the middle and at the crease along that incision. Three weeks out, whatever might be destined to not heal will reveal itself. It is hard to tell from the photos whether there is infection because the lighting is ? If there is redness, tenderness and drainage it is likely the wound is infected. If there is no drainage and just the white tissue that demonstrates compromised healing, but with medical care will do well. Typically the white tissue will be cleaned off to allow the pink tissue to heal and come together, typically with daily washing and application of a topical ointment - vaseline, aquaphor, medihoney or an antibiotic. If you cannot access your surgeon an Urgent Care of ER would be the best option.Best of luck to you!

Jeffrey J. Roth, MD, FACS · Answer

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.

Rady Rahban, MD, FACS · Answer

It is difficult to determine what the diagnosis may be without properly examining a patient. The only way to know is to have a physical examination with a surgeon. It is normal to have some spotting of blood the first week, however, it is completely abnormal to have any drainage after surgery. Leakage of pus coloring along with pain and inflammation can be a sign of infection. Cultures ordered by your physician can determine whether or not you have an infection. It is crucial that you contact your surgeon immediately and inform him/her of your issue so that treatment could be started immediately. I hope this has helped.

Raja Mohan, MD · Answer

please see your surgeon as soon as possible for recommendations on how to treat this and make sure it gets better.

David Nicholas Csikai, MD · Answer

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.

Steven Wallach, MD · Answer

It looks as though you had some wound separation and areas that have delayed healing. Keep a close eye on them and do the wound care instructed by your surgeon. Follow closely with your surgeon. Often this heals with conservative care and does not usually need further surgery.

Robert L. Kraft, MD, FACS · Answer

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

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

Answers (19)

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