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

I don't understand why they aren't healing..I am completely healthy & have followed all of the post-op instructions. At my last appt (week 4) the nurse cut out a large knotted suture & my PS gave me an antibiotic ointment and some kind of wound care (fiber) product to put in my incision. My left side is the worst...it's not sealed, but there is tissue there. The right side has a small hole on the incision. What can I do to get these to heal??

Doctor Answers 13

Delayed wound healing

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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 

Foreign Body Reaction to Suture Material

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.

Wound care

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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

Suture reactions

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.

Breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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. 

Incision problem

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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 

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

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.

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

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It sounds like the sutures may have prevented healing. Once they are removed, things should heal. Follow up with your surgeon. 

Breast augmentation recovery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is difficult to advise you without any photos of the area.  I recommend that you call your surgeon to discuss your concerns.  Be prepared that you may need to go into the office for an examination.

Not sure

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

When you relate the story of the "knot" that was removed, it makes me wonder if you have suture that is being pushed out of the wound by inflammation.  We usually call this, "spitting sutures."  This usually resolves as the suture dissolves or is removed from the wound.  Sometimes, topical or oral antibiotics can help.  If the wound is only open at the surface of the skin, the implant is probably safe underneath.  However, if this opening goes deeper beneath the skin it can be very problematic and could cause you to lose your implant.  I would contact your PS very soon if you are uncertain about the extent of the wound disruption.  

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.