Why Did my Breasts Open Underneath Leaving a Deep Hole?

I received a breast reduction 10 days ago. Now I have a deep open hole under both breasts. I want to know if they can be can be closed. The doctor wants me to put damp gauze in the incision several times a day with a pad. What can be done? Thank yoy

Doctor Answers 7

Why Did my Breasts Open Underneath Leaving a Deep Hole?

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I am sorry to hear about the complication you are experiencing. These types of complications can be quite distressing to patients; unfortunately, sometimes the wounds do look worse before they begin to look better.
Close follow up with your plastic surgeon will be in your best interests; sometimes removal of a exposed suture and/or removal of any unhealthy tissue will expedite healing. In my opinion, a "wound care specialist" referral is not necessary assuming you are under the care of a well experience board-certified plastic surgeon.
Wound care regimens will differ from one plastic surgeon to another. Generally, this will involve application of some type of sterile dressing ( in my practice I use a non-stick dressing covered by a sterile dressing). You should have peace of mind that these types of wound healing problems generally go on to heal over the course of the next several weeks, often without long-term sequelae. Also important to concentrate on a healthy diet, including good protein source. Sometimes (depending on the width of the open wound and the appearance of the scar in the longer term), scar revision surgery may be helpful down the line. Best wishes.

Wound issues after reduction

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are quite common and your surgeon  is treating you appropriately to allow that wound to heal.  You cannot simply suture the skin edges at this point.  I think you will be surprised as how well it does heal but revisions can always be pursued down the road if needed.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Open wound after Breast Reduction

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I am sorry to hear about your wound healing issue.   I would also recommend conservative wound care, such as the wet to dry dressing, until your incision completely heals.  After 6 months, it is then safe to perform an in office scar revision.    Wound healing issues require a lot of patience as they do take time to fully heal.   It is difficult to say how long without seeing a picture.    

It is important to give the wound time to soften prior to revision or the risk of further wound healing problems or infection can escalate.   Please be patient and stick to your plastic sugeon's wound care rec's very carefully.  I wish you a safe recovery.

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Wound break down from a breast reduction

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The most common location for ischemic wound breakdown from a breast reduction is at the base of the inverted T.  This is the area that is the furthest from the blood supply and under the most tension. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Open wound on breast after reduction

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I have seen this happen a few times after a breast reduction.  It commonly occurs at the junction of the inverted-T skin edge closure.  It occurs because the poor blood flow in the skin and tissue flaps created during the surgery.  Things that can contribute to poor blood flow are 1. too much undermining of the tissues during the reduction, 2. too thin of skin flaps created, 3. history of smoking 4. vascular disease from various causes (such as diabetes), 5. too tight of a skin closure, 6. garments and bandages that are too tight that are placed after surgery.  And sometimes it occurs even if the above have been avoided. 

The best line of treatment after a wound has established is usually conservative wound care with frequent dressing changes and wound debridements (cleainings).  Occasionally antibiotics are needed if there are signs of infection.  The wound can take several months to heal completely.  It will most likely leave a scar that you or your surgeon may want to revise and improve.  I usually wait about 6 months after the wound has completely healed over before revising the scar   This scar revision surgery could be done under a local anesthesia if it is not too complex. 

An immediate direct closure of the wounds will most likely fail and the wound will recur. 

Thanks for your question.  All the best!

Steven Svehlak, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 31 reviews

Breast Reduction Incision Opening

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Thank you for your question. The bottom part of the T incision of a breast reduction has the greatest amount of tension and the blood supply is put under stress.  This leads to either delayed healing in some cases and separation in others.  Wound care as you are doing until healing progresses is the appropriate treatment.  If there are no pre-existing risk factors for separation such as smoking, diabetes, or excessive tension then delayed closure can be appropriate in some patients.  You will need to discuss your individual situation with your surgeon.  The good news is that despite this problem, most patients do very well and still have a good outcome.  Best wishes on your recovery.

A deep hole on the breast reduction incision

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From your description, it seems like you have a small wound dehiscence at the T-juction  where 3 scars meet.  The T-juction is a weak/stress point of your incision and it can break down.  It seems like you are doing the right thing.  You should  continue to follow your plastic surgeon's recommendation on local wound care; it should heal with time.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.