I am 5 weeks post-op from Breast Augmentation and my incisions are still not fully healed/closed.

I'm sorry to hear that you are having problems.  The vast majority of patients do very well following breast augmentation without any wound healing problems. It is difficult to comment specifically on your situation without viewing photographs and/or a visual examination.



But it is very conceivable that what you are experiencing is a reasonably common (although infrequent) reaction to the braided dissolvable suture material right under the skin surface.





Because this suture is a foreign material inside the body, you're immune system can sometimes mount a reaction to it. This inflammatory reaction around the suture often times causes a little red bump (that resembles a pimple) to develop in the skin..  A whitehead will sometimes then form, and then the skin will open.  A small amount of drainage sometimes occurs. This is often referred to as a "spitting suture".  Sometimes these spots will then crust over, only to open again shortly thereafter. As long as the suture material remains in place, this reaction usually continues.  Once the suture material is removed, the stimulus for the inflammatory reaction is gone, and the open area usually closes and heals fairly quickly.





This reaction to the suture material may occur only at one spot, or sometimes can occur at multiple locations.  If it occurs at multiple locations along the incision, these reactions can sometimes occur simultaneously, or sometimes occur over a period of time (one pops up here, and then another pops up over there later on, and then another occurs in a different location even later, etc.)  These reactions are possible as long as the suture material exists underneath the skin.  Once the suture material has dissolved and degraded these types of reactions will no longer occur.  It is for this reason that you're surgeon removed the suture material at the wound opening; leaving the suture material in place usually just perpetuates the problem.





Keeping the wound clean, and applying a small amount of double antibiotic ointment to the open areas is usually sufficient. If the redness is much more generalized, and not just confined to the site of the underlying suture, or if multiple sutures are spitting at the same time, then oral antibiotics may be helpful.





A couple other important notes… Smoking may certainly aggravate this process and delay wound healing further.  You should avoid tension across the wound closure to minimize additional skin edge separation.  This foreign body reaction to the suture material is generally quite superficial and usually occurs just around the stitches that are located right beneath the skin surface.  If the wound opening becomes more significant, or extends deeper beneath the skin surface, then it is very important that you contact your plastic surgeon.  More extensive or deeper wound openings are going to carry a higher risk for infection and/or implant loss.





For now it is important that you follow closely with your plastic surgeon.  If you have any questions, you should not hesitate to contact him or her for further recommendations.  Best wishes.

Thank you very much for enquire.

It's too early to make value judgments with only 1 month after a rhinoplasty.Swelling after a rhinoplasty depends of the surgery complexity.In this regard, the nasal swelling Post-op It can last from two weeks to two months.To reduce this swelling, I recommend you perform delicates daily lymphatic drainage massage therapy over the face (around the nose) avoid sun exposure, and take pain/inflamation pills, as your surgeron precribe you.Kind regards, Dr. Emmanuel Mallol Cotes.-  

Sometimes the suture material can irritate the skin and cause open areas. They usually resolve with some time. Make sure you follow up with your surgeon regularly to assess your healing 

Thank you for sharing your question.  Unfortunately without an in-person examination or full series of photographs it is difficult to offer definite advice but if your incision issues were due to the suture material "spitting" through the skin this should resolve quickly now that the knot has been removed.  In order to prevent additional issues be sure to maintain close follow up with your surgeon until you are completely healed.  Best wishes.

Thank you for your question.

Without a photograph it is difficult to tell. However at this point it is possible you're not healing because of a small amount of infection or a technical issue that caused separation of the wound edges. In order to optimize your chances for healing going forward, you should try to keep the area as dry as possible with as little rubbing as possible. I would check with your plastic surgeon, but I would probably recommend no underwire bra if you have an open area along the imf incision.



 Hope that helps,

Christopher C. Chang, MD

Washington DC, Maryland, and Virginia 

Thank you for your question and I am sorry you are having a hard time.  Sometimes these things happen and they will usually heal quickly with proper wound care.  Follow your surgeons recommendations and please call him/ her if you have any changes in your wound.

It's hard to tell without photos. I would suggest calling your surgeon's office. This is something he/she should be made aware of. Best of luck to you. 

I think following closely with your surgeon and following their wound care instruction is the best thing to do at this point.

Dissolvable sutures create a soft tissue response in their degradation that cause inflammation and sometimes extrusion or exposure.  Its a very common problem.  You do have to stay on top of it with topical wound care to avoid infections, etc.

Some people spit sutures. It sounds like that is what is happening to you. It is sometimes possible to revise the incision with external sutures, but these can leave marks on the skin. If you smoke, quit. Be sure that you aren't putting tension across the wounds. Other than that, it sounds like your surgeon is handling this appropriately.