How quickly should skin necrosis be treated after breast reduction surgery? (Photo)

I tend to be very conservative in situations like this.  the breast is very forgiving and letting nature take its course often works well.  if I t starts to get red or odious then I woukd start trimming the tissue away . be patient

Thank you for your pictures and questions. Sorry to see you are having this problem. I would follow closely with your surgeon and allow him or her to dictate what to do next. Some surgeon prefer to leave the eschar intact and let the skin demarcate while others prefer to debride the dead skin. Both are probably acceptable options but you do need to follow some instructions on local wound care to prevent infection, so discuss that with your surgeon.Hope this helps!

Dear ShyOCGirl,This type of wound is not uncommon after breast reduction. It is usually caused by poor blood flow. I would suggest you to follow your surgeon's instructions and keep your wound clean and covered. It can take few weeks or months for wound to fully heal. Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

as appreciated and in your case, your surgeon may have delayed a little to allow a clear demarcation of what is viable and what isn't.  With the yellow tissue developing around the black eschar, a debridement can now be done.  Why debride?  Your wound must be clean before it will start to heal so getting rid of the dead tissue will facilitate healing.

Once the necrosis has demarcated and is able to be lifted from yellow tissue below and around it, it can and should be cut out down to healthier bleeding tissue to promote healing. Most eschars (the black necrotic scab) can be prevented from becoming infected with the use of topical products like Silvadene but once the demarcation is clear, there is no advantage to leaving that layer intact. Your surgeon should be debriding this soon and if not, you may want to get another opinion from a plastic surgeon who also does a lot of wound management. I will say that this location is the most common for delayed healing problems with breast reductions and breast lifts as it is where the skin flaps are under the greatest tension and blood supply is farthest from its origin. The good news is that with debridement and wound care, the resulting scar is often only a bit wider than what would have resulted otherwise and you can consider minor scar revision after a long period of scar maturation down the road.

I am sorry that you are having this problem.  This area is one of the commonest places for this to happen post breast reduction where there can be quite a lot of tension in the tissues.  I would suggest  waiting and let the black (eschar) separate on its own.  Sometimes it is necessary to remove it surgically but only if an area of infection develops underneath it.  You are best taking advice from your plastic surgeon who can examine the tissues and determine the best treatment.  Best wishes.

Patience is your friend here. I leave the eschar in place until it loosens up a little more than it has. The surrounding yellow area represents more viable tissue and the surrounding pink is more blood supply coming in to help with healing. I usually have my patients put some type of antibiotic ointment on and keep the area covered. Eventually this will heal and doing it slowly will help the skin stretch. Once it is healed and you have given the scar some time to mature you can always revise the scar.

Thank you for the question and photos and sorry for your problem but at this point you need good wound care so see your surgeon or other wound care specialist in the area Dr Corbin