Breast reconstruction: Do I have cellulitis or something else? (photos)

Question

I had a double mastectomies in september with expanders at 300 cc each. The drains were removed 3 weaks later, then a day or 2 after I develpoed swelling, heat, pain and redness on the right breast. I have being on antibiotics since. He decided to removed and replace both with the implants. Also, I had capsular contractor of the right expander as well, which was kind of sideways. One week later after exchange and no difference and the right looks deformed. Any advice?

Joel M. Stewart, Jr., MD · Answer

I definitely agree with ultrasound of the breasts in this setting. 5 months is quite a long time to be on antibiotics.
Perhaps the remaining skin is just edematous (swollen) and there is no underlying bacterial infection.
Follow up with your surgeon and let them know your concerns.

Hilton Becker, MD · Answer

It appears that you have fluid retention in the tissues.This may take several months to resolve If it gets any worse see your surgeon

Ali Sadeghi, MD, FACS · Answer

Hello and thank you for your question. The best advice you can get is from a personal in office consultation. Based on the picture there is definitely more swelling in the right breast. If you had an infection and the implants were replaced while you were on antibiotics, there is a chance the replaced implant may also be infected. It could also be secondary to the localized swelling and trauma from the mastectomy. You should consult with your PS and allow him/her to do a physical examination to assess the problem. Keep in mind that there are other options in reconstructing the breasts after mastectomy, (i.e. flaps: DIEP or PAP or GAP or others) that will provide natural and permanent reconstruction with minimal risk of infection. Good luck and I hope this was helpful.

Darryl J. Blinski, MD · Answer

Great pics but without in person second opinions can not offer a dx. Sounds like subacute infection. Removal expanders might be best option.

Robert Whitfield, MD · Answer

You can definite appreciate the swelling in the tissues.  I don't know if this is due to the skin and fat over the implant being swollen or something else.  There are several ways to examine the area for fluid but it is usually evaluated by ultrasound if it cannot be determined on your physical examination.

Breast reconstruction: Do I have cellulitis or something else? (photos)

Answers (5)