Infection After Breast Reduction?

I had breast reduction surgery 6 months ago and everything went great. I am very pleased with the outcome and the healing went well. However, two weeks ago, I noticed a hard lump under my right breast on the incision line that was very tender. I had a business conference that was a week long, so I didn't go see my doctor immediately.

By the time I returned, that lump was black and blue and was the size of a gumball. It was very painful. I called my doctor and was able to get into see her this morning. She cut it open and drained it and said it was full of pus. She has sent off the "gunk" to have it examined. When I asked her what could have caused this after 6 months, she didn't have an answer.

I exercise regularly and don't know if I could have caused this by lifting too much weight or if it is a fluke thing. Do you have any insight on what caused it and if it could be serious? The entire breast is now sore and painful. Thank you.

Doctor Answers 7

It sounds like a suture granuloma

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Suture granulomae are reactions to the suture used to close your prior surgery. You need to be followed by your surgeon until the wound closes and it may require a scar revision six months to a year later. You are unlikely to have done anything to make this happen.

Orange Plastic Surgeon

Most Infections Following Breast Reduction Surgery Occur in the Immediate PostOp Period

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Most infections following breast reduction surgery occur in the immediate post-operative period.  Occasionally infections occur late in the patient’s recovery and this is usually related to a stitch abscess.
This problem occurs when infection develops around one of the absorbable internal sutures that are used during breast reduction surgery.  This can result in a marble sized abscess or granuloma that requires drainage and treatment with antibiotics.  This is a relatively simple problem to deal with if treated early.  If diagnosis and treatment are delayed, then more significant problems can result.
This problem requires follow up with your surgeon.  With appropriate care, this should represent a minor setback with no long term consequences.

Breast Reduction Surgery Complication?

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Thank you for the question  and the precise description of your problem.

The two most common culprits that would explain your situation are suture related infections and/or fat necrosis.  Since  you have been treated you should be fine.

Best wishes.

Recovery from Breast Reduction Surgery

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I’m glad your surgery went well and you were pleased with the result. It sounds as if you developed a small abscess along the scar and your surgeon treated it appropriately by draining it. It could be related to a suture that did not completely dissolve sometimes referred to as a suture granuloma. This should fully resolve. Unlikely that is in any way related to your activity.

Leo Keegan, MD
Manhattan Plastic Surgeon

Infection after breast reduction

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Breast reduction surgery is a very popular and effective way to contour the breasts and remove tissue that may be causing symptoms such as pain or discomfort. If done properly, the surgery is very effective and safe. However, like all surgeries the risk for infection does exist. If you have developed an infection, symptoms that you may experience may include pain, tenderness, a hard area, redness, hot to the touch, or drainage. If it is a deep infection you may not experience all of these symptoms but may have pain or firmness deep within your breast. It is possible that this inflammatory response may change your surgical result.

Your best bet is to work with a board-certified plastic surgeon was great deal of experience in breasts contouring surgery. They will be able to assess your tissues, determine if you have infection, and let you know if this inflammatory response will change your breast appearance.

Breast reduction infections

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An infection 6 months after a breat reduction is unusual. It could be a stitch absces that became larger, of an inclusion cyst that got infected. It really could be from almost anything like local trauma. The important thing is to treat it.

Delayed infection after large Breast Reduction

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Dear Rbhageman,

Post surgical complication are usually classified as acute or delayed. Although infections, if they occur, are usually seen in the first few weeks after surgery, some uncommonly may be seen later on. This does NOT sound like a typical infection though.

In your case, several things may have happened: As Dr. Di Saia opined you may have had a reaction to one of the deep sutures used to hold the reduced breast together (a granuloma). Another possibility may be that a small portion of the breast fat died (fat necrosis) and the resulting fluid (not necessarily pus) made its way to the surface and drained itself. Although scary to most non-surgeons,once all the fluid drains out, with proper wound dressings the open area usually heals nicely and may NOT require any additional surgical revision.

I would follow closely with your doctor and I am sure this will resolve to your satisfaction.

Peter A. Aldea, MD
Memphis 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.