Infection after gynecomastia surgery. What should I do?

Question

Had my gynecomastia surgery 22 days ago, surgery went well,,five days later noticed some yellow stuff and then there was discharge coming from it and a culture was taken and then it came up as a pseudomonas aeruginosa infection, treated it with ciprofloxacin for a 9 days now and there is still some discharge coming out. Took another culture test a few days ago and the reports show a methicillin resistant staphylococcus. What should I do? Please guide me by checking my pics

Tim Neavin, MD · Answer

Thank you for your question and for your photos. Based on your photos provided, I do see some discharge. I would advise you to follow up with your original surgeon.

Joshua A. Greenwald, MD, FACS · Answer

Best course of action is continued follow up with your plastic surgeon for culture specific antibiotics and a consultation with an infectious disease doctor if your PS feels it is indicated.  Dr. G

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs and I am sorry to hear of your infectious complications.  It appears that you require additional antibiotics to help treat the MRSA.  I would recommend speaking with your surgeon as soon as possible to avoid the need for IV antibiotics.  Best wishes.

James Knoetgen, III, MD · Answer

I'm really sorry you’re going through this — persistent infection after gynecomastia surgery can be a serious complication if not addressed promptly.
Please
1. See your surgeon immediately or a doctor as soon as possible
Your culture shows MRSA (methicillin-resistant Staphylococcus) — this is a more aggressive and antibiotic-resistant bacterium.
Your doctor will need to reassess the wound in person to determine if:
•	There is a persistent collection of pus (abscess) that might need to be drained surgically.
•	The antibiotic you’re currently on isn’t appropriate for MRSA and a change in medication might be required (such as Trimethoprim-Sulfamethoxazole [Bactrim] or Linezolid or Vancomycin, depending on sensitivities and severity).
•	There might be some dead tissue that needs removal (debridement) to allow proper healing.

Eric Desman, MD · Answer

Sorry to hear that you are having a problem. Infection after this surgery is very rare - probably in the 1-2% range. At this point, please continue following up with your plastic surgeon. You may need another round of antibiotics - Pseudomonas & MRSA can be difficult to clear with one round of antibiotics. Once cleared, it will likely take several months for the tissues to settle down from inflammation and for you to see your final results. Try to be patient and follow your PS advice. Good luck.

Connie Hiers, MD, FACS · Answer

You need to be followed closely by your surgeon, and possibly may need IV antibiotics. Please call your surgeon's office today and ask to be seen.

David E. Berman, MD (retired) · Answer

your culture report will inform your PS what antibiotics that you should be on. i would take them for about 10 days and then reassess. you should be fine with antibiotic treatment. you may need a second course but this will be determined at a later day. infections are uncommon but can happen to anyone, so it is no one's fault. david berman md

Infection after gynecomastia surgery. What should I do?

Answers (7)

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