Is this an infection 14 months after breast reduction srugery? What should I do to treat this? (Photo)

Question

I am 34 years old female, recently had breast reduction surgery (about 14 months ago). About 3 days ago, I noticed there is puss coming out my nipple stitches (this is supposed to be a dissolveable stitches, but few blue strings still not completely gone). I am having a constant pain around the nipples area, and there is hard lump, about pea size. My question is, is this an infection ? Or something else that are more serious ? And what should I do to treat this ?

Richard A. Bartlett, MD · Answer

Hi Stash18, from what you are describing, I believe you may have a "Spitting Suture". This occurs when a buried suture works its way to the surface. These usually resolve on their on and will fall out, however, given the inflammation and pain you are experiencing, it would be worth while to reach out to the surgeon who performed your breast reduction to assess the site and determine whether it is a spitting suture or an infection. If you are experiencing a fever, foul smelling puss, increased redness/inflammation, I would encourage you to reach out to your surgeon sooner than later as it may have become infected and may require oral or topical antibiotic treatment.

Wayne I. Yamahata, MD · Answer

It appears that you have a low-grade infection. A timely visit to your surgeon would be advised. If he or she is not available then you should seek diagnosis and treatment with your primary care physician, urgent care clinic, or emergency room.

Joel Patrick Maier, MD · Answer

It looks infected with the bright red skin and pain. You should see a doctor today so things do not get out of hand.

Ajaya Kashyap, MD · Answer

Thank you for your query. Based on your photographs, what you have is a “stitch abscess” from an unabsorbed suture in the area. Although the stitches may be absorbable, they can occasionally cause a reaction like this, with localized infection. Your surgeon will be able to take care of this by removing this stitch , which is usually a little deep. Other blue stitches may be removed at the same time. All the best!

J. Timothy Katzen, MD, FACS · Answer

Hello STASH 18 in Doha, thank you for your question regarding whether this is an infection 14 months after breast reduction surgery and what you should do to treat it. Thank you for your questions and your pictures. This is not a forum to be asking medical advice questions like this. You should go to your plastic surgeon immediately. If it is a serious infection, it needs to be treated immediately. Call your plastic surgeon now!

With that said, it appears that you do have an infection. The infection is probably due to a blue suture called a Prolene suture. During a breast reduction, a permanent blue suture is placed around the areola to minimize areola spread. It appears that the suture may be infected. Most plastic surgeons would give you 10 to 14 days of antibiotics. The antibiotics usually treat the infection. However, if the infection continues, you may need a small surgery to remove the suture. At a later date, the suture may need to be replaced. Either way, it is imperative that you contact your plastic surgeon immediately. Good luck. I hope I’ve answered your question regarding a possible infection 14 months after breast reduction surgery and what you should do to treat it.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Carlos Marciales, MD · Answer

Hello, apparently if there is a localized infection, the most advisable thing is that you go to a doctor to clean you and send you treatment, for the moment it does not look very serious but it can get worse if you wait a long time

Derek Fletcher, MD · Answer

The most likely explanation is that one or more sutures or suture fragments are infected.  Some surgeons use permanent sutures around the circumference of the areola to prevent the areola tissues from stretching.  If that is the case, than the sutures need to be removed.  You should see your plastic surgeon for a physical exam and have them manage this for you.  There is a low risk of other potential causes of breast skin redness that must be ruled out.

Scott C. Lindsay, DO · Answer

Thanks for your question! You should call your plastic surgeon as soon as you can to have an in person appointment. Unfortunately, we won't be able to diagnose you via RealSelf. Good luck!

Ronald J. Edelson, MD · Answer

You probably have a buried suture that hasn’t dissolved and needs to be removed. Go back to your original surgeon to check it

Nancy de Kleer, MD, FRCSC (Plast) · Answer

I'm sorry to hear you are having a problem.
With the redness and lump I notice on your photo, I recommend you immediately start with a gauze compress soaked in warm water to help draw infection out. After 10 minutes, you can apply some over the counter antibiotic ointment if you have some in your home that is not expired. 
Next, phone your physician's office or your surgeon's office to be assessed.  At minimum you require a topical antibiotic ointment, however, depending on findings at in person exam, you may also need antibiotics by mouth. 
As far as the cause, it is most likely one of two things:  A suture abscess - you mention that there are some blue strings that you still notice now an then, or a small cyst - this may have developed because of the stitches that were placed there.  
Regardless of the cause, currently you have an infection that needs to be treated.  Once the infection is gone, the small lump will either disappear on it's own, or a small surgical procedure may be recommended to remove it.
The lump is not anything more serious, like cancer or other illness.   It is due to the surgery/infection.
All the best to you,
Dr. Nancy de Kleer

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Is this an infection 14 months after breast reduction srugery? What should I do to treat this? (Photo)

Answers (14)

BREAST REDUCTION PROVIDERS NEAR YOU