Infection, aftercare, and necrosis from surgery mid March with board certified plastic surgeon. (Photos)

Question

A day after surgery part of each areola turned puffy/purple. Surgeon texted me not to worry, but gently move breast around. These became necrotic. I Am debrided weekly and have open wounds. After first debridement I felt sick and GP said infection. Surgeon says he bets there's no infection. cultures show Staph infection. I'm losing confidence in my surgeon and I am concerned. Should I seek a second opinion? Both look much better, but wet to dry dressing still pulls out smelly green substance.

Daniel Brown, MD, FACS · Answer

Thanks for your questions and photos.  Sorry to hear that you are going through all this after your surgery!  Unfortunately this can happen any time incisions are made and a large amount of tissue is removed from the breast due to decreased blood supply and swelling from your breast reduction.  Your wounds look quite clean and appear to be healing (pink granulation tissue present).  There may continue to be yellowish tissue that will require debridement in order to hasten the healing of the wound, but it sounds like your surgeon is doing the absolute right thing in having you do dressing changes daily and doing sharp debridement weekly.  As far as any significant infection, it is impossible for me to absolutely determine from just a photo, but there does not appear to be any surrounding redness, you did not mention having a fever or increasing pain which would all be signs that you have an infection.  Open wounds can become colonized with bacteria as the protective covering of your skin is not intact and allows bacteria access to the wound - however, this does not mean that you have an "infection" (which would lead you to have the signs outlined above).  The best treatment for these types of wounds is local daily wound care and weekly sharp debridement.  Unfortunately, there is no quick way to correct the tissue breakdown/wound that you have.  It will heal slowly over time but should cause no further problems if you continue to do as you are now.Best wishes!Daniel Brown, MD, FACSBoard Certified, American Board of Plastic SurgeryMember, American Society of Aesthetic Plastic SurgeonsMember American Society of  Plastic SurgeonsCastle Connolly Top DocReal Self Top 500

Daniel Barrett, MD · Answer

Dear luckylaw,this type of wound is not uncommon after breast lift or BA. It is usually caused by poor blood flow. I would suggest you to consult your plastic surgeon, follow your surgeon's instructions and keep your wound clean and covered. It can take few weeks or months for wound to fully heal. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jon Ver Halen, MD, FACS (license suspended) · Answer

Hello and thank you for your excellent question. Wound healing issues are not uncommon after a breast reduction or lift, and are generally more common in patients having large reductions, and if you have other medical problems. Based on the photos, the wounds appear to be healing well. It can take weeks for these incisions to heal fully.  I suggest that you follow your surgeon's recommendations. Sometimes, patients will benefit from a scar revision after they are fully healed, and the scar has matured. If you have any questions, call our office for assistance. Good luck!
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc”
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council

Infection, aftercare, and necrosis from surgery mid March with board certified plastic surgeon. (Photos)

Answers (3)

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Infection, aftercare, and necrosis from surgery mid March with board certified plastic surgeon. (Photos)

Answers (3)

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Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.