How Long Before Tissue Necrosis Heals After Breast Reduction?

I had a breast reduction done back in december and am pleased with the results other than one of my breasts is still open at the inverse T. It is still draining and bleeds fairly easily.

I have been using bactroban cream on the site for several weeks. My PS believes it may be fat necrosis. Just curious how long these types of things could take to heal, and if there are any other options to try and get the wound to heal quicker.

It is healing but EVER so slowly!

Doctor Answers 14

Recovery From Breast Reduction Is Dependent Upon the Amount of Tissue Necrosis & Patient's Wound Healing Characteristics

Wound breakdown and tissue necrosis occasionally occurs following breast reduction surgery. Several factors contribute to this phenomena. These include the weight of the tissue that supports the blood supply to the nipple/areola complex, thinning of the skin secondary to constant gravitational forces, limited blood supply to the most distant portions of the skin flaps, and chronic bacterial colonization in the area of the folds beneath the breast. In addition to this, external factors such as cigarette smoking and steroid use may also contribute to wound breakdown and soft tissue necrosis.
Most cases of wound breakdown following breast reduction surgery can be managed with local wound care. This includes removal of the necrotic tissue and dressing changes. Some patients may require the use of a VAC, which shortens healing times by applying continuous suction to the wound. In severe cases, removal of the necrotic tissue followed by flap reconstruction or skin grafting may be necessary.
When wounds heal with dressing changes, they form granulation tissue in the base of the wound, which gradually decreases the size of the wound. Once this occurs, new skin forms around the margins of the wound and migrates in an inward direction eventually closing the wound. While this is occurring, the wound is pulling its edges together to ultimately decrease the size of the scar.
Wound healing times are entirely dependent upon the amount of tissue necrosis and wound healing characteristics of the patient. Occasionally, patients may need a scar revision once wound healing is complete, but this is uncommon. Even when wounds break down and patients undergo a prolonged period of would healing, they still report high satisfaction rates following breast reduction surgery.

Secondary healing in breast reduction

Breakdown of the incision especialy at the "T" is fairly common after breast reduction surgery. When they drain, it may take a few weeks to possibly a few months to completely heal. This had to be followed carefully by your doctor.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 23 reviews

Wound Healing after Breast Reduction?

Thank you for the question.
This type of wound healing does occasionally occur after breast reduction surgery.
How long it will take to heal depends on the size of the world and the status of the underlying tissue. This may be anywhere from a few weeks to an additional month.
The important part of this process is close follow-up with your plastic surgeon, who may able to help with light debridement and/or  removal of foreign body (such as suture).
Best wishes.
 

Tissue healing after breast reduction

 

Breast reduction surgery is physically very well tolerated with few incidents of complications in wound healing. However if you should experience a wound breakdown or a scar separation, discuss your concerns with your plastic surgeon. They will typically recommend wound care which will consist of changing dressings and removing dead or dry tissue. The amount of time it takes to heal these wounds depends on the size and depth of the wound. Although this is inconvenient, these wounds to heal well and usually leave an acceptable result although the scar may be wider than initially hoped for.

Tissue necrosis can take a few months to heal

Make sure your surgeon takes a close look at the wound to make sure nothing correctable is there - like a suture. Otherwise it can take weeks to months to close.

Best Regards.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 25 reviews

Difficult to say without examining you

It is hard to know exactly what is happening without an exam, but in general things should have healed up by now. If indeed there is some fat necrosis present, you may need a repeat trip to the OR and possibly excision of this necrotic tissue-- this will probably give you the best chance at a speedy recovery.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 141 reviews

Tissue necrosis with breast reduction

I would agree that once the dead tissue is completely removed, your wounds should continue to heal.

In the meantime, keep in close contact with your surgeon and notify her/him of any change in the quality of the drainage or any other associated symptoms.

A pulsatile shower head may be a very effective method of cleansing the wound.

While bactroban is an excellent antibiotic (bacterocidal), it can also slow the grow of healing wounds (cellulocidal) and once you do not need it, you should switch to a less potent antibiotic cream, such as silvadene.

Discuss your concerns with your surgeon

Hang in there.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 72 reviews

Fat necrosis may take awhile to heal

If you developed fat necrosis after a breast reduction (devitalized tissue) which is still present in your breast, then it may take months for your body to metabolize the tissue and heal the area. If there is a significant area, then you may need another minor operation to debride the tissue or drain the area. This is best evaluated by your surgeon. Good luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 72 reviews

You might need some debridement

The "T" is the fragile area for healing in a breast reduction. If yours separated, generally it should be totally healed by now. The fact that it is shrinking and bleeds easily are good signs but the rate of healing may indicate that some necrotic tissue is still present and may benefit from debridement to hasten the healing.

Can't answer, but...

The T is the most vulnerable area in general, due to tenuous blood supply. The length of time to heal depends on the extent of necrosis, size of the area, and your ability to heal (reduced with some diseases, and SMOKING!).

Fat necrosis is another issue. Fat necrosis may resolve over time if it is small, or may leave hard lumps. If significant, your doctor may need to debride the fat necrosis to clear any infection and facilitate healing.

Whatever you come up with, be sure your doctor is in the loop.

sek

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.