Is this an infection after breast reduction?

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.

Great question. It is very odd to have the presentation you had, as typically an infection etc. is unlikely to present that far out from surgery. Most likely, since it is your incision, is a reaction to one of the sutures that your body had an inflammatory response to. This can lead to an infection or simply be inflammation. It's possible you had it for a while and it finally erupted through the skin just recently. Either way it should get better after drainage and go away.
-Dr. David Mattos, New York Plastic Surgical Group

This is usually caused by a dissolvable suture that didn't dissove and your body is treating like a foreign body or infection.  Drainage and antibiotics and wound care will resolve it.  Sometimes it also can be a microscopic piece of skin that is under the incision line and causes a cyst after several months that can be infected.  Finally atypical mycobacterium can cause late infections where there is suture remaining in the area.  If you get repeated bouts of this, your surgeon should check this.  Best wishes.

This most likely sounds like a problem with your body not dissolving the absorbable sutures, or forming a granuloma around it and eventually bringing it to the surface. Alternatively, you may have had some fat necrosis (non viable tissue that can sometimes be present after a reduction) and your body pushed that to the surface. This type of inflammation can rarely cause inflammation or infection of the entire breast as you are describing, so make sure you talk with your surgeon if the drainage did not seem to improve your overall pain and redness, as you may need to be put on an antibiotic.

It is unusual for infection at 6 months but if you had a small cavity with whats called a seroma/fluid filled cavity or a repeated reaction to the suture used (some times seen in any wound closure with any number of suture materials) can lead to what has happened to you and this is the most likely scenario. 
And I want to take time out to put what I'm about to say into perspective because there is no cause of undue concern here-naturally, your surgeon would have stepped back and looked, examined and investigated a new lump in your breast appropriately as you would with ANY new lump in the breast in ANYONE presenting in our office- your cause appear to be obvious in the first instance(but warrant an overall diligent investigation by a specialist of course) because in Australia a woman has 1 in 8 chance of developing cancer in their life time and these numbers are not too different in the US. Such thought is always in the back of our minds as plastic surgeons because unfortunately we do see some rare and unexpected cases. 
Again this is not to cause anyone any undue concern and off the topic except to say that regular breast examination/screening as per your local guideline that is tailored to you and your age and the risk that is specific to you is vital and something none of you with breasts should ever neglect (for example these examinations and investigation if needed needs to be more frequent if you have a family history of breast cancer or are known to have genetic mutations such as BRCA-1 or 2 gene among others that predisposes you to a life time higher risk of developing breast cancer). 
In my practice if you have no family history and no other risk factors but you are above the age of 35 I  get a base line mammogram (some X ray pictures used in screening). Then I get another one after the breast reduction when the wounds have completely settled down just so that I have some comparison in the future should I ever need it and this is done because once I've rearranged you breasts in a way I've "reset" the breast tissues. Interestingly though, breast reduction reduces your risk of developing breast cancer because, and this makes sense, you have less breast tissue now that you had a reduction, therefore you have less breast tissue that can turn into a cancer.
Wish you the best in your recovery.
Dr Leo Kim, Specialist Plastic Surgeon in Sydney

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.

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.

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.
 

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.

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.