2 weeks PO. I've noticed the skin has started peeling around the T incision. Is this normal? (photos)

Question

I’ve been using bacitracin and non stick gauze sponges, should I continue doing so?

Kenneth Hughes, MD · Answer

Peeling is normal.  I usually do not cover the incisions. Recommend that you keep the area dry and use no ointments.  Every surgeon has different post op care instructions, so follow those provided by your PS. This will heal on its own with time.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Donovan Rosas, MD · Answer

The "T" point is an area common for delayed healing. It is a vascular water shed (i.e. relatively diminished blood supply where 3 flaps meet) under high tension.Patients will typically exhibit some degree of dehiscence (separation) and epidermolysis (sloughing of the upper layers of skin). With some local wound care, these will typically heal secondarily without further intervention.As always, discuss your concerns with a board certified plastic surgeon (ABPS)Donovan Rosas MDBoard Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
Real Top 100RealSelf Hall of Fame

James D. Frost, MD · Answer

It is very common to have some peeling of skin in these areas.  Peeling of the top layers of skin will result in the pink color you see.  This color will likely return with time.  But I don't see any open wound.  I do not see an indication for Bacitracin or non-stick gauze.  Actually you may do some harm with those combined as you will keep the area too moist as if you soaked in the tub too long.  Speak with your surgeon for more personalized directions but I would just keep some dry gauze in your bra and maybe some body lotion over the healed scar.

Daniel Barrett, MD · Answer

Dear Js601,
I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong. Based on your photos, it looks like some skin is peeling and there is no wound separation. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Matthew A. DelMauro, MD, FACS · Answer

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) I'm sorry to hear about the trouble you have had after surgery. Wound healing complications are not uncommon after breast reduction surgery. There are many risk factors for wound healing complications; not knowing your history makes it difficult to identify your risk factors. Local wound care is the treatment. You should follow up closely with your plastic surgeon. Best of luck!
Matthew A. DelMauro, M.D.

Robert Drielsma, MBBS, BSc, FRACS · Answer

Its not uncommon to experience some wound breakdown following breast reduction surgery.  You have had an anchor pattern reduction and the “T” junction is angry and breaking down which is very common with this technique. This typically heals well without any intervention.  You should however discuss with your surgeon and obtain their advice and follow your surgeons post operative guidelines accordingly.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,This the area that has the most tension. So periodically we see small areas of separation.I would continue with the recommendations of your plastic surgeon, you should do well. Good luckStephen M. Davis, MD, FACS
Certified: American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery
Member: American Society of Plastic Surgeons
Member: RealSelf Hall of Fame

Oren Paul Mushin, MD · Answer

Thanks for your question. Wound issues around the T-point are the most common sites of slow healing. An in-person examination is needed, but it does appear that the area will heal well with time. I would consult with your plastic surgeon and follow his/her advice for best wound care practices.

Ahmed Abd EL Gawad, MD, FEBOPRAS, FRCS(Plast) · Answer

Hi, thank you for sending your question and photos. I would be delighted to offer my advice. 
Please don’t worry about it  this is the commonest issue to happen after breast reduction surgery  
The T junction is the weakest are of the whole scar  
It should heal on its own within the coming few weeks 
I hope this helps.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
The operative procedure of breast reduction involves
separation of the skin and soft tissues of the breast from underlying breast
tissue.Segments of tissue are removed. The skin and soft tissue is then advanced downward and the excess skin
and soft tissue is removed in an inverted "T" fashion.  
If there is impairment of the blood supply to the breast skin and
soft tissue, the segment of the flap the greatest distance from its blood
supply may not survive (at the junction of the inverted "T" flaps).
The cause of the blood supply impairment can range from effects
of smoking, diabetes mellitus, vascular disease, previous surgery in the
area (disrupting the normal blood supply), infection, or may totally inapparent.  
Treatment varies, depending upon the degree of tissue loss. You appear to be exhibiting relatively minimal tissue blood supply impairment. Most wounds of this nature will heal uneventfully with a regimen of local wound care.
Follow your surgeon's directions.
Best wishes...

2 weeks PO. I've noticed the skin has started peeling around the T incision. Is this normal? (photos)

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