My right breast itchy red & white bump along incision. I had Breast Augmentation 4 weeks ago on Friday. Any suggestion? (photo)

Hello, a common cause of an itchy bump 4 weeks postop is a suture that is extruding from the incision.  If this is the case it can be trimmed by your surgeon.  However, you will require a proper exam by your surgeon to determing what is going on.

This appears to be a stitch which is spitting from the wound.  This needs to be addressed by the plastic surgeon.

It appears as though you have a spitting stitch along your incision line. When dissolvable sutures are used to close your incisions, sometimes your body "spits" them out before they have a chance to fully dissolve. If the area is open, I recommend my patients apply a dab of bacitracin antibiotic ointment and cover the area with a Band-Aid. If there are any signs of infection such as redness, warmth, or foul smelling yellowish drainage from the area, you should call your surgeon immediately. If the stitch is still underneath the skin, a gentle massage and warm compresses can help bring it to the surface. Once it comes to the surface, it can be clipped using a pair of tweezers and fine cuticle scissors at home or at your surgeon's office. The itching you are experiencing is most likely a normal process of wound healing. Again, any concerns should be addressed with your plastic surgeon. Best of luck with the rest of your recovery!

Heather,  This likely is an absorbable suture that hasn't fully been absorbed by your body.  In order to dissolve a suture your body causes an inflammatory response that breaks down the suture.  This can sometimes cause a bump or a raised red area.  Make sure you let your surgeon know and he/she will exam you to make certain that's what is occurring.  Also, scars take 6-12 months to fully mature and soften.  During the first few months they tend to be slightly raised and red until they mature and fade.  As always, make sure you see a board certified plastic surgeon to assure you're getting the best possible treatment.  Good luck and I hope you have a speedy recovery.  

Thank your posting your
photo and question. With any post-operative concerns you have, it is best to
check in with your surgeon and let them know. They will appreciate the open
communication and know the best route to take for treatment. Best of luck. –Dr.
Coan

The bump and small hole could represent a stitch abscess, but the photos shows redness of the breast which may suggest an infection.

As long as your incision isn't red or warm to the touch, you are most likely experiencing a suture abscess.  It is not actually an infection; so, don't be concerned.  Most sutures are absorbed by the body.  Occasionally, a couple of the sutures near the skin may extrude or 'spit.'  This is very common and will resolve.  Keeping the incision covered to prevent any additional irritation may be helpful. 

What you are experiencing is common after this procedure, and will subside with time. A suture is working it's way to the surface, what is known as suture spitting. The area will heal in time, and the best treatment is to keep the area clean and dry, and prevent it from rubbing on your bra. I recommend my patients to just cover the area with a breathable, gauze dressing. It is not necessary to apply ointment to the area, the ointment can delay healing by keeping the area moist and from healing as quickly.