Bump on end of incision. Should I be concerned? (Photo)

Question

Its been over a year since my breast augmentation. I had under muscle with internal stitches. About a month ago a small protruding bump popped up and now it is bigger and red. It does not hurt. It is on my left breast at the end of my incision. Should i be concerned? Is this normal? I mostly wear sports bras and dont wear wire bras. Im 41, 135lbs, 5'4, olive complextion. Dark hair

Carlos Marciales, MD · Answer

Probably it’s a knot of the sutures that they use to close the wound inside, sometimes the body couldn’t absorb the knots and expels to the outside, you need to go with your surgeon to remove that, it’s not something to really worry

Daniel Barrett, MD · Answer

Dear Affectionate931923,
I understand your concern. Based on your photos, there is a chance that suture is the cause of your bump. 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 or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question. This "bump" could represent several things including a hypertrophic scar or a suture granuloma. If it is getting larger, changing color, creating issues, etc. I would seek follow up with your surgeon for an in-person examination and input on how to best proceed given their knowledge of the surgical technique used.

Brian K. Reedy, MD · Answer

Hi & thanks for your question!
This is most likely a suture coming to the surface. Reach out to your surgeon to have this looked out. Best wishes!

Camille Cash, MD · Answer

From your photos it appears there is a suture knot under the skin.  This can be addressed in your surgeon's office.  It will require only minor home care and they tend to heal quickly.

Connie Hiers, MD, FACS · Answer

You have developed an area of hypertrophic scarring which can be treated with steroid injections. Please visit with your plastic surgeon.

Mats Hagstrom, MD (license on probation) · Answer

You must likely have a bacterial contamination of the knot at the end of the running absorbable suture.
This will either resolve on its own, cause the skin to erode creating some drainage, and then heal over or continue to fester on and off.
You could try a weeks worth of anabiotic’s or go back to your provider and have them and dig out the end of the suture or suture knot. 
This is unlikely to lead to a serious complication, but could leave a slightly more visible scar at the end of the incision line.
This is sometimes referred to as spitting sutures, and it’s one of the consequences of using absorbable suture material close to the skin surface. This is not at all uncommon and any plastic surgeon can help you deal with it. Different providers may have different opinions on how to handle the situation.
My assessment is only an estimate and making an accurate assessment would require an examination and a bit more history.
Best,
Mats Hagstrom, MD

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