After Breast Reduction, Experiencing Open Wound and Drainage. Should I Have Surgery to find Necrosis?

I had a breast reduction in November 2011. As of February 2012 I still have an open wound and fat neucrosis drainage. This occurs along the edge of an area of the aerola on one brest and is about 1.25 inches long/1.25 inches deep. My doctor has performed a debrievement twice (1/24/12 and 2/21/12)with no healing progress. He now wants to perform surgery and open the area of the breast down to the chest wall searching for the dead tissue that is causing the drainage. Any suggestions???

Doctor Answers 5

Breast Reduction - Open Wound and Necrosis

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I'm obviously sorry for the problems you're having.

It's impossible to make an informed recommendation via this forum as you need to be assessed by someone who can examine you.  However, in my (fortunately) relatively limited experience with this issue, the wounds usually heal on their own pretty well over time.  It can take a while (months) but they usually do heal.  If the patient has any underlying medical issues, such as diabetes, etc., the process can take longer.

But if only relatively minor debridements were performed before, then a more significant one may be helpful now.   If there is any question, you should seek another opinion from a board-certified surgeon who can examine you in person.

Again, I'm sorry but I hope that this has helped,

Dr. E

Fat necrosis, when does it end?

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fat necrosis is common, however, this has been going on way too long. my concern is that the debridement was done twice already without resolution. a second opinion is not unreasonable and also consider and imaging study to look for an undrained collection that may be contributing to the ongoing process. best of luck to you.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Breast Reduction and Necrosis?

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Thank you for the question. I'm sorry to hear about the complications you have experienced after breast reduction surgery. Unfortunately, these types of complications can occur after breast reduction surgery. I am glad to hear that your plastic surgeon is following you closely. There are different ways to handle fat necrosis;  obviously, your plastic surgeon is in the best position to advise you given that he knows your situation best. Generally speaking, I prefer "conservative”  treatment,  involving debridement procedures ONLY  if absolutely necessary. Often, the body has a way of eliminating unhealthy tissue (the drainage you are experiencing)  naturally.  Aggressive debridement has the downside of potentially removing healthy tissue unnecessarily. Ultimately, the less tissue removed the better probability of an aesthetically pleasing and result ( less contour deformity). I hope this helps.

Open wound after breast reduction

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Soemtimes patient's develop fat necrosis. This can occur for many reasons( smoking history, very large breasts, obesity, to name a few).  Often it can heal on its own, but may require surgical debridement. Without examining you and following the progression it is very difficult to say what you need done, but if the woudns re not healing it sounds reasonable to make sure the wounds are clean.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Open wound and necrosis following reduction

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Fat necrosis following breast reduction is not common but it does occur and can be a problem. Removing the necrotic tissue will speed healing but in my limited experience, it is very difficult to get all the necrotic tissue. Eventually it will heal, with or without debridement, but it can take a long time. I had one patient (who did not want surgery) who healed after about a year and her final result was fine. Good luck to you.

Margaret Skiles, MD (retired)
Sacramento Plastic Surgeon

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.