Why would my breast augmentation incision burst open? (photo)

Thank you for posting your experience. It's a shame you had to go through this. This is very rare and is most probably a combination of factors. I believe the silicone in the ScarAway Bandaid contributed to the scar opening up. And when it comes to BA and massages, every surgeon has a different rule book, but for me, massages three time a day may be a little too aggressive.The wound takes about 2 months to reach considerable matureness and strength. Too much physical activity before this time frame may result in complications such as this. That said, I believe the problem might of been the early use of silicone trips (ScarAway Bandaid) in combination to some sort of trauma or excessive physical activity. The silicone in the Scaraway Bandaid helps rearrange collagen in the scar and in turn helps avoid hypertrophc or keloid scar formation. This rearrangement can actually make the scar weak if used before the scar has matured enough. Some manufactures recommend using the silicone strips after 21 post-op days, for twelve hours a day only. I always recommend to wait at least a full month before evaluating the possibility of scar treatment as well as the need for it, because not all scars need scar treatment.In plastic surgery most of our scars have tension. This means that plastic surgery scars usually have vectors pulling from opposite directions and therefore, may take longer to mature then then other scars.  It is impossible to see how deep the opening was and if indeed it was close to the implant. However, if their is any doubt as to the integrity of the implant, the correct course of action is always implant removal.Hope this helps and and best of luck!Dr. Miguel Mota 

Dear jscott238,I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello and thank you for the question. It's hard to know for sure why this happened. It is unusual to have this degree of implant exposure without having an underlying problems (infection, hematoma, etc). It is unclear from this picture how deep this opening was and why exactly the implant was removed. I presume you were evaluated by a  board-certified plastic surgeon after going to ER. Nevertheless, I would go back to your surgeon for an evaluation and recommendation on further management.Best,Pejman Aflaki, M.D.Johns Hopkins-trained plastic surgeon

So sorry  to hear that you had this problem after your surgery.     It is true that there is little strength to the wound beyond the sutures used to close the wound, and at 2 1/2 weeks, the sutures are also weaker than initially.        It also appears that you had fairly large implants and there may have been a little too much stress on the incision, especially with massage.    I personally don't recommend massage early, but that varies by physician preference.   Such a problem is quite uncommon, but is a risk.      Discuss your problem with your surgeon.     I hope you have no further issues.  

Most commonly this wound opening results from too much activity too soon after surgery, assuming you are otherwise healthy.  You need a full 8 weeks for the scar to reach maximum strength.  This is uncommon, yet does happen from time to time, and  unfortunately this has happened to you.  At 2.5 weeks out the deeper tissues of the incision are still healing    Once open the implant needs to be removed to avoid infection or capsular contracture.  In any case, once it is healed and infection free, the implant can be replaced.

I doubt this was because of an infection.  The usual reason might be because of a localized hematoma or fluid( seromas) collection.  It doesn't sound that you had a localized collection of blood or seromas, however.  I don't have my patients massage their breasts this early after surgery, but some physicians do.  I strongly believe that you have to carefully follow up with your Plastic Surgeon to see what the current recommendations may be.  Replacement of  a new implant may be able to happen reasonably soon.Good luck to you.Frank Rieger M.D.  Tampa Plastic Surgeon

I am sorry to hear about your experience with the emergency room. At only 2.5 weeks after surgery and a photograph that doesn't suggest infection or ischemia, I would think that some type of overt pressure may have allowed some of the sutures to pull away. Once the implants out, it is certainly easier to treat any infection. After a month or two, usually the implant can be replaced. Best of luck.

Hi and welcome to our forum!
Wound opening (dehiscence) after breast augmentation is rather unusual, but does occur, usually as the result of a postoperative hematoma or infection, a tight closure, a large implant, overactivity or post surgical trauma (including overly aggressive massage).
If significant wound contamination or infection is present or if the wound was open for an extended period of time, temporary implant removal is recommended.
Continue followup with your plastic surgeon. You should do well.
Best wishes...