Will skin grow over this hole left from open wound? (Photo)

Question

I am 8 weeks PO breast lift (NO implants!). I do not smoke and followed every direction and still had open wounds under my breasts. The wound itself has officially closed, but I'm left with awful indentations in the skin where the wound was. Will this ever get flat? How look does it take for skin to grow over it? Can I do anything to make sure it looks smooth?

Richard H. Tholen, MD, FACS · Answer

All wounds need to heal completely before judging "final" appearance. That takes 6-12 months, not 8 weeks.Optimal healing requires adequate circulation, and smoking impairs circulation. But avoidance of smoking does not guarantee that every breast skin flap has adequate circulation for healing, only that any kind of nicotine exposure will worsen whatever circulation the skin has. Yours was "almost" perfect, but you still had some healing difficulties. This is uncommon but does occur, even in non-smokers.The good news is that time and further scar maturation over 6-12 months will usually improve things considerably. The indentations will flatten and fill out, the redness will fade, but the scars will also probably stretch a bit, as most do. This will still be perceived by most patients as improvement overall.Your scars will not stay "awful." Sorry you feel that way now. Can you do anything to "Make sure it looks smooth?"  NO (to the "make sure" part). But using scar pads and ultraviolet avoidance over the next 6-12 months will help your situation considerably. Best wishes! Dr. Tholen

Ankur Mehta, MD · Answer

Thank you for your question and your photos. The area of your concern is the well known "T-junction" of a full scar or wise pattern mastopexy. This is an area that can commonly break down after surgery because this is where the least amount of blood flow is. When I perform these type of mastopexies I take many precautions to try and prevent this situation and even then sometimes this happens, although not frequently. If there is an open wound in this area, it usually heals well with simple wound care and time. If you feel as though you have healed completely without open wounds and there is an indentation, you can wait for about 6-12 months and then usually only a small revision is needed. This can sometimes be done as a clinic procedure with some local anesthetic. You should definitely have a discussion with your plastic surgeon and see what his recommendations are. Ankur Mehta MD

Vincent N. Zubowicz, MD · Answer

Anytime two incisions cross the trauma to the skin can generate a small wound healing issue. Such a problem is noted in the photograph. With proper wound care this should heal uneventfully.

Rodney E. Schmelzer, MD · Answer

This is a common area of wound breakdown secondary to tension with breast procedures.  It will almost always fill in with skin and improved over time with good hygiene and wound care.  There are some things that help to improve or flatten scars, but you should be followed by your surgeon.  Silicone sheeting, creams,scar massage etc can all improve upon scars over time in the post operative time period.  Collagen can remodel for 12-18 months, so follow up with your surgeon.

Brooke R. Seckel, MD, FACS (retired) · Answer

Yes but proper wound care is needed to speed the healing process. See your plastic surgeon for advice on proper wound care.

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