Concern that my transaxillary Incision Were Not Done correctly or not healing correctly. Advice? (photo)

Question

The pictures are 3 weeks post breast augmentation. I still have tenderness and can't extended my arms all the way up, I expected that to be normal. What's not normal is the way they look. One has a bump under the stitching and what looks like a tendon that protruding when I extend my arm. Is this normal or should I be concerned?

Nana N. Mizuguchi, MD, FACS · Answer

Incisional scars, in general, will take up to a year to totally heal.  The appearance will continue to be better even after one year.  Your description of a "knot" under the incision is consistent with the possibility of a dissolvable suture that will probably resolve within 6 months.  Massage may very well help reduce the knot and raised portion of the scar.  Gradually increase the range of motion of the arms with the goal of having full range of motion within a couple weeks.

Ali Sajjadian, MD, FACS · Answer

Thanks for your question . it's possible that the bump you're feeling under the scar could be a suture. Dissolvable sutures, which are intended to dissolve and incorporate into the body over time, are frequently used by surgeons. But occasionally, especially if it's deeper in the tissue, a little knot or a section of the suture may still be there.   
Scar tissue may be the cause of the lumps and cord-like feeling you're experiencing. A light massage can enhance implant integration, ease scar tissue, and lessen the growth of scar tissue. A little massage can reduce the chance of developing capsular contracture.   Morever, massage can assist the implant settle into its right place, lowering the likelihood of asymmetry and ease discomfort and tension in the breast tissue.  
Important Considerations about massaging:
-Follow Your Surgeon's Instructions: Your surgeon will provide specific instructions on when and how to perform massage therapy.
-Start Slowly and Gently: Begin with gentle, circular motions, gradually increasing pressure as the healing process progresses. 
-Avoid Excessive Pressure: Excessive pressure can irritate the incision and delay healing.     
-Pay Attention to Your Body:: Stop receiving massage treatment right away and speak with your surgeon if you feel any pain or discomfort.
Once more, speak with your surgeon first: The best person to evaluate your particular circumstance is your surgeon. They are able to assess the region, identify the reason behind the cord and lumps, and suggest the best course of action.
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian 
TRIPLE Board Certified Plastic Surgeon

Joshua A. Greenwald, MD, FACS · Answer

Too early to tell about your scarring.  It can take up to a year.  The visible cord may be a thrombosis superficial vein - not worrisome but should be treated by your PS.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures. Your incisions are not healing as well this traditional transaxillary breast augmentation incisions typically do. I would continue to follow up with your plastic surgeon. I would allow at least 8 months to 12 months worth of healing before considering any revision.Good luck.Earl Stephenson Jr MD DDS FACS

Curtis Wong, MD · Answer

or your surgeon wouldn't be in business.  But you do have some inflamed incisions that you must simply allow time for healing.  You can always bring this to your surgeon's attention as your surgeon is most familiar with how the armpit wounds heal.  And if an untoward events occur, your surgeon can be ready to manage it.

Darryl J. Blinski, MD · Answer

This is a very common outcome of the axillary incision location. Only time and/or scar revision will help...

Scott E. Kasden, MD, FACS · Answer

It appears that you have inflammation, if not an infection going on in the incision.  The "white" is likely not a tendon, but some unhealthy tissue associated with the above.  It would be unfair to criticize the surgeon or technique, as I am only basing this on pics.I would recommend that you visit with the doctor and have this looked into.  Chances are that you have a suture that is causing the irritation, and it can be removed easily to correct it.best.sek

Steven Wallach, MD · Answer

The scars that you are developing look a bit hypertrophic already.  It is best to review with your surgeon to see what recommendations he would make for scar care. You might end up requiring  a scar revision after a year.

Steven M. Camp, MD · Answer

Thanks for sharing your photos.It does appear that your incisions are a bit irritated.  I would recommend close and careful follow up with your plastic surgeon.  I think with good attention, and some scar massage with appropriate items you will ultimately heal nicely.I am very meticulous with my closure of transaxillary incisions to avoid the early irritation after surgery.  I would recommend to avoid deodorant and shaving until the redness and raised areas calm down.Best of luck to you.Steven Camp, MD

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the photos and description.  The cord you feel may be Mondor 's syndrome and could be a thrombosed vein (actually quite common) but I would follow up with my surgeonDr Corbin

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