4 weeks PO my breast has had discharge. Should I be worried?

Question

I'm four weeks post-op. My breast has been leaking moderately for appprox 3 weeks. Am I lactating, or is this post-op discharge? Should I be worried?

Richard J. Bruneteau, MD · Answer

Although your question isn’t
totally clear, I’m assuming that you’re referring to post-operative nipple
discharge.It’s important to realize
that breast surgery can occasionally stimulate lactation.This is usually a self-limited process that resolves with
the passage of time.Nevertheless, it
should be evaluated and monitored by your surgeon.It’s important to rule out other causes of nipple
discharge and to make sure that secondary complications such as infection don’t
develop.When these steps are taken,
most patients have a relatively uneventful recovery.

David Shafer, MD, FACS · Answer

Anytime that you have leaking from your incision, especially for an extended period of time, then you need to be evaluated by your surgeon. You need to go soon rather than later if you have any pus or fever or chills.

Otto Joseph Placik, MD · Answer

Did you have implants as well?
Is this discharge from the nipple or incision?
Does it a have an odor?
Is it white (pus-like), bloody, clear, or oily?
Is the skin black?
Do you have a fever or are the wound edges red?
All of these may be indicative of the underlying problem and may represent different causes. 
Generally lactation occurs from the nipple with a clearing whitish drainage with minimal odor and frequently ocurs with placement of implants.
Please consult with your physician to evaluate other possible causes.

Brian S. Glatt, MD, FACS · Answer

I fully agree with the other opinions given. You need to see your docor immediately for this. Your prognosis does also depend somewhat on the character of the drainage (e.g is it clear? red? foul-smelling? purulent?) Also - is the outer skin red at all? Signs such as these may indicate an infection or the presence of tissue that is not healthy inside of your breast (fat necrosis). Most likely, however, you have a fluid collection (seroma) which should be drained and followed closely afterwards. If your doctor is unwilling to see you or deal with this problem, then find another board certified plastic surgeon in your area who should be readily qualified to handle the situation appropriately and, just as important, provide the proper follow-up.

Steven H. Williams, MD · Answer

There are several questions that will help clarify this matter.
Is the discharge from the nipple or from the incisions?
Is there redness?
What does the discharge look like?
Are you having fevers or chills?
There are many possibilities.
The discharge could be a draining liquifying hematoma or serous collection.  This may or may not require treatment (drainage typically).
The discharge could represent an infection - however it would be atypical for an infection to be brewing for three weeks without larger systemic issues.
The discharge could also represent liquefying fat.
As always, these concerns should be addressed with your treating physician.  I hope this helps.
Steven Williams, MD

Tom J. Pousti, MD · Answer

Thank you for your question.

	It is difficult to know if you are having "leaking" from the nipple/areola or the incision.  Discharge from the nipple/areola after breast surgery because the milk ducts have been manipulated.  This discharge should stop spontaneously.  If the "leaking" is from the incision lines, you should make sure your plastic surgeon sees you and  examines you to make sure that all is fine.

	Best Wishes.

Olivia Hutchinson, MD · Answer

Nipple discharge following breast lift surgery may occur and usually resolves spontaneously. Any discharge from the incision(s) needs to be evaluated immediately for possible infection, wound healing problems, or underlying fluid collection.

Pat Pazmino, MD, FACS · Answer

It is possible to have a small amount of drainage after a breast reduction. The most important factors are where the drainage is coming from and the quality of the drainage. Sometimes patients have a minimal amount of clear or yellowish drainage from a certain point along the incision line. This may be due to the liquefaction of fat underneath the skin. If the drainage proceeds for a long time it may be a symptom of a deeper collection or a deeper problem that your plastic surgeon will definitely want to know about. If the drainage is of a dark or greenish color and if it has a foul odor, this may indicate a deep infection in which your plastic surgeon will want to know about this immediately. The best thing to do is to take care of yourself and see your plastic surgeon as soon as possible and discuss your concerns.

Hisham Seify, MD, PhD, FACS · Answer

I'm assuming you mean nipple discharge. I have seen patients having milk discharge in the peri-operative time. I would alert your plastic surgeon to it. He will follow it for some time and if needed additional tests might be ordered. If the discharge is from your incisions, you need to show it to your doctor ASAP. Best of luck!

Bahram Ghaderi, MD · Answer

If you drainage is from your incisions, then you should see your surgeon ASAP to discuss treatment options as you very likely have an untreated infection. If the discharge is from the nipple, that can happen sometimes if you have pressure from an implant. Have you discussed this with your surgeon? You may also have fluid collection - seroma - that needs further drainage. The most concerning cause would an untreated infection. I would recommend you discuss this with your surgeon right away.

4 weeks PO my breast has had discharge. Should I be worried?

Answers (20)

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