Is It Common for Breast Implant Incisions to Rip Open?

Question

My breast incision ripped during my massaging techniques 25 days post op. My massaging techniques were assigned to my from my PS. Is there any reason why this would happen? Is it a common mishap? I rushed to my PS and he numbed and cleaned me and stitched me right back up in his OR. He put me on two different types of antibiotics. I didn't show signs of infection when he saw me and he said that my internals looked healthy. Why did I rip open then? Can this happen again?

Young R. Cho, MD, PhD · Answer

Thank you for your question and for sharing your experience with us.  Sutures tend to lose their integrity with every week that passes.  Scar tissue integrity tends to strengthen with every week that passes.  At some point, the dissolvable sutures placed superficially lose their integrity all together and the inherent strength the incision is not quite ready to take on all the stress alone.  It is for this reason I tell my patients that I tend to get most worried between weeks 2-4 as this is usually when there is no discomfort and activity levels start to increase and breast incisions may not be able to handle everything.

Vincent N. Zubowicz, MD · Answer

Massaging a scar makes no sense. You have demonstrated a negative consequence of the maneuver. Disrupting a wound at 25 days requires a good deal of force so you probably were very aggressive. But even gentle massage is traumatic and causes the release of histamine.

Richard H. Tholen, MD, FACS · Answer

Obviously, your massage techniques were more vigorous than your incision's tensile strength at 25 days! This could be because you did your massage too strongly, or because your incision had "poor" healing, bacterial contamination (the earliest stages of infection), because you had a closure whose strength was not reinforced by suture choice or technique adequately, perhaps bigger implant size than the optimal capacity of your breast skin, or a combination of all of these.

	Incision breakdown is uncommon, but unless this is happening to lots of your surgeon's patients, it's no one's "fault."

	It could happen again if you overstress the re-repair. I suspect your surgeon asked you to stop or reduce the vigor of your massage. He may have even re-closed your incision with an additional layer, stronger sutures, or more of them!

	Just be careful and don't overdo anything until you are completely healed. Best wishes!

Steven Wallach, MD · Answer

An incision opening at 25 days after surgery is not common. Without having more facts it is hard to guess why this happened. Were you massaging too vigorously? perhaps.. Is there a medical condition precipitating this? I can not say withou seeing you, getting a history, and performing an exam.

Ralph R. Garramone, MD · Answer

It is not common for this or any incision to open at 25 days after surgery. If it is the result of massaging too aggressively, you certainly are massaging too aggressively. The massage does not need to be that aggressive.

	The risk with this operation is exposure of the implant.

	By your description it appears as though your doctor treated you appropriately and I would follow up closely with him over the next couple of days and weeks.

	Thank you for your question.

Peter E. Johnson, MD · Answer

Implant incisions should never open up as the implant is at risk. The immediate repair has saved the day, and bet the massage is on hold. What you were doing was more than the healing tissue could withstand. And two antibiotics (one might suffice) indicates just how alarming the situation was for your surgeon. Rest and heal, massage is of questionable benefit anyway.

	Best of luck, peterejohnsonmd.com

Peter A. Aldea, MD · Answer

There is always a possibility of dehiscence (separation of a stitched surgical wound). But it is extremely uncommon in Breast Augmentstion wounds which are commonly closed under no tension. Such a complication is more likely to happen in smokers, radiated tissue, underlying infection or massive bleeding which is unrecognized or ignored. 

	Hope everything works out well for you.

C. Bob Basu, MD, MPH, FACS · Answer

This is very rare in breast augmentation/implant surgery. But it can happen. The good news is that you saw your PS immediately. He/she intervened and it sounds like they addressed the issue. Please follow your PS's postop care instructions and take it easy to give a few weeks time to let the incision heal and mature. Best of luck.

Tom J. Pousti, MD · Answer

Thank you for the question.

	Although not common,  your experience of incision line opening can occur;  the important thing is that it be treated appropriately.  Based on your description of the events, it seems like your plastic surgeon has done just so.

	Although repeat separation can occur,  this would be unusual.  I would suggest continued close follow-up with your plastic surgeon.

	Best wishes.

Is It Common for Breast Implant Incisions to Rip Open?

Answers (9)