How Long Before Tissue Necrosis Heals After Breast Reduction?

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.

Tissue necrosis can occur and when it does it is usually at the junction of the inverted T scar.  It is usually treated with dressing changes and debridement. Occasionally creams or liquids containing silver are used to decrease the healing time.

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.

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.

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.