Is This Fat Necrosis, Infection, or Deep Suture Abscess? (photo)

Question

I'm 7 weeks post bilateral breast reduction. Since post op week 3 I've been dealing with this infection. I've been on a round of Keflex and Bactrim and neither have done much for me. My plastic surgeon doesn't seem worried and says it's either a deep suture reaction or fat necrosis. It started with red and irritated areas along the incision and has developed into to this. The incision is mushy and has a serous red drainage. No odor and only occasional sharp pain. Any advice is appreciated.

Remus Repta, MD · Answer

Hello,

	Thank you for the question and the photos.  You have inflammation of the area surrounding your incision.  This can be from the sutures, from a superficial infection, or from mild fat necrosis near the incision line.  It does not matter as which of the causes of the inflammation you have as much as if it is improving on its own.  If the area is getting better with time I would recommend that you continue until healing has stopped and the inflammation has gone away.  At that time or sometime afterwards you may choose to undergo a scar revision if the scar appearance is not acceptable to you.  If the area does not seem to be getting better you would likely be well served by a revision surgery to either remove the sutures or remove the fat necrosis.

	All the best,

	Dr Remus Repta

Steven Wallach, MD · Answer

WIthout a formal exam it is tough to answer this question. Are you spitting sutures and getting local abscesses?

Darryl J. Blinski, MD · Answer

Yes you have wound issues whether is fat necrosis or suture abscess or both is only determined in an in person examination. Seek second opinions or continue with your surgeon's plans. Does your surgeon have the circle?? The "circle" of excellence and safety? Yes the logo for the ASPS!

Is This Fat Necrosis, Infection, or Deep Suture Abscess? (photo)

Answers (3)