Does over activity cause the nipple to separate from the skin? (Photo)

Question

I am 15 days post augmentation. As you can see from the pictures my breast look really bad. I was told this was due to over activity. Regardless, I don't know what to expect. If it clears up am I going to have scars? How bad? Is scar tissue eay to fix? My doctor took blood yesterday and a culture. I have another appointment tomorrow. Does over activity cause the pulling apart and infection or is it the other way around? Please advise! Also, my Steri tape was taken off 4 days post op.

M. Scott Haydon, MD · Answer

Thanks for your question and the photos. I'm sorry that you are having issues with healing. Over activity can cause the disruption of the closure. It looks like you have a very large implant. The internal pressure of that large an implant causes stress on the closure. When the augmentation is combined with a lift it is especially problematic. As long as you are not doing heavy lifting, exercise, smoking, etc. this normally will heal up. It will take 4-6 weeks to have a better idea of your outcome with regard to the scarring. Keep visiting your PS to make sure there is no evidence of infection. Best of Luck!

Paul M. Parker, MD, FACS · Answer

Tough problem which can be caused by a variety of issues, over activity included. It sounds as if your surgeon is monitoring you closely and that is appropriate in order to get you to heal as quickly as possible. Once healed, scar revision can be performed, if indicated.

Pejman Aflaki, MD · Answer

Hi,
Thank you for the question. It appears you had an augmentation-mastopexy (combination of a breast lift and implant). It looks like blood supply to the lower portion of your left areola is compromised, causing skin necrosis. There is also some wound breakdown of the vertical incision and around the areola. There are many reason why this could happen (excessive tension on the skin at the time of closure, too much skin undermining, over dissection of breast tissue, etc). It's hard to say without examining you, but both necrosis and wound breakdown could be superficial; the necrotic skin will slough off and it heals with some scarring that can be revised once everything heals. Wound breakdown, if stays superficial and does not progress, can also heal spontaneously, but may leave a slightly wider scar. It's important that you see your surgeon frequently to make sure things are moving in the right direction (meaning you don't develop deeper infection involving the implant pocket or exposure of the implant). Best of luck!

Trevor M. Born, MD · Answer

Dear Marmar14Thank you for your question and photos!  I am sorry that you are having difficulty.  Wound separation can be caused by trauma, swelling, tension of closure, smoking, infection, stitch reaction, poor circulation, fat necrosis and allergic reaction to tapes. Please follow up with your surgeon,With Warm RegardsTrevor M Born MD

Curtis Wong, MD · Answer

but if your nipple was already dusky post-op, I would speculate that there is more to the story here.  So did you have darkened and cool nipples post-op?  And did you really do anything that you were not supposed to do?  If you did not, then this is entirely a result of your procedure and the surgeon's technique.  You will have some scars but they often heal better than you could ever imagine.  If your areola sloughs, that is more significant issue and scarring is common then.  Focus on healing and getting through this so you won't impact the implants and if you didn't do anything but your surgeon blames you for this, I don't have many nice things to say about him/her.

Georgios Ziakas, MD, FACS · Answer

From the pictures it is apparent that the surgery was breast lift with augmentation. There is some wound separation on the Rt and some nipple areola complex skin necrosis on the Lt. These may happen after this type of surgery. Local wound care and close follow up with your surgeon is advised.

Sanjiv Kayastha, MD · Answer

Yes, overactivity can cause your incisions to separate but it is not likely the only cause. It is also possible that the issues you are having are due to a number of other causes. It is not totally unusual to have some issues like your pictures demonstrate following augmentation mastopexy. You have some compromised blood flow and tissue that has not survived. Continue close followup with your surgeon. After things have settled down and adequate time has elapsed whatever scars you develop can be revised.

Benjamin Chu, MD, FACS · Answer

Many women who have had breasts lifts will experience some level of wound disruption.  This is because the incisions is only held together with small sutures and the individual is way more powerful than any stitches that are placed.  It takes around two months for any internal scars to form and prior to that a lot of movement causes the incisions to separate.  Once separated you really need to put your arm in a sling and treat the open areas with Silvadene to allow the incisions to heal.  Being active only causes further wound separation.  The area that's most susceptible to disruption is the T-junction of a full breast lift.  You should treat any open site with Silvadene antibiotic cream.  After the incisions are healed you may consider scar revision at a later time.

David Rosenstein, MD · Answer

Hi,I am sorry to hear you are having some delayed wound healing. This can be a common issue that arises after this surgery. Is it caused by over activity? It can but usually that is not the cause in most cases. Only you know how active you were and if you were over doing it after surgery. It does seem like your doctor is taking the right steps in your post-op care. It will take a little bit longer for your incisions to heal and a revision may be needed. Depending on how severe the seperation is will determine your final out com. If it's a mild seperation it can easily be revised and it will then heal normally. Without seeing you in person it is hard to give you a definite answer for your case. Just hang in there and know these things can happen after surgery, stay positive, and once healed you can discuss revision options with your surgeon. Best wishes!

Ricardo Ventura, MD · Answer

hello thank you for your question and provided information as well...I am sorry to hear that you are going through this situation , but are a series of factors that can affect the heart primarily the little rest , the little irrigation of blood in the nipple and the tissues, in terms of the separation the most common factor is the constant movement of the arms either to lift heavy things or raise , all that affects and delays recovery , be sure to go where your plastic surgeon and follow each of their instructions for a speedy recovery.

Does over activity cause the nipple to separate from the skin? (Photo)

Answers (14)

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