20 days post op Breast aug. I'm taking cipro. Should I remove the white tissue when cleaning this? Or what should I do? (photo)

Thank you for your question.  I would avoid using Neosporin and consider simple vaseline as Neosporin can cause skin irritation that makes the situation more confusing if one is worried about an infection.  I would also stop the Cipro if you cannot tolerate it.  The separation that you have is like due to a suture spitting out in the incision.  Keep in touch with your plastic surgeon, especially if things change before your visit.

Sorry to hear about your problems. When your sutures were
removed the redness you had was likely related a small skin edge separation
that exposed the underlying suture, or it was related to a sterile abscess that
developed in response to the underlying suture material. Neither are major problem. Sometimes the body reacts to
the suture material (as a foreign body) and mounts a reaction to it. That can
create a red irritated spot that opens and sometimes drains a small amount. This
type of process will sometimes resolve on its own, and other times it resolves
only after the offending suture material is removed.



The ongoing redness may be related to the suture, but may
also be related to the Neosporin ointment under the Band-Aid. For some
individuals prolonged use of Neosporin can produce an allergic-type skin
reaction with redness and irritation. The relatively occlusive nature of the
Band-Aid may aggravate this. This reaction occurs as a result of the neomycin
in the Neosporin (triple antibiotic ointment). I usually recommend Polysporin
(double antibiotic ointment), which contains only bacitracin and polymyxin, but
not the neomycin. Switching to double antibiotic ointment may help; and always
use a minimal amount of ointment. Covering with a piece of woven cotton gauze
may also help and be less occlusive than a Band-Aid.



Ciprofloxacin is not a very effective antibiotic against skin
bacteria, and in many of these localized "reaction to the suture" situations
an oral antibiotic does not offer much benefit. The area does not look
infected, and if the Cipro is irritating your stomach it is probably reasonable
to discontinue it (at least that is what I would tell my patient, but I would
have used a different oral antibiotic). It is best to check with your surgeon
before discontinuing the medication.



Keep the area clean with soap and water. It is probably not
wise to expose it to ocean or pool water. Do not pick at the area too much. See
your plastic surgeon when you return. He can remove the suture or lightly
debride the area if that is indicated. Ultimately this area should heal with
out much consequence. Best wishes.

Sorry to hear you are out of the country dealing with this situation.  Keep the area clean, and dry.  Apply the antibiotic ointment after cleaning.  Keep taking your Cipro until it's all gone.  Follow up with your plastic surgeon once you get back in Chicago.  Good luck