17 days post op from a lift/aug(265cc implant) and worsening wound over the past week....when to worry? (photo)

Question

I live 8 hrs from my PS(we live rurally, NO it was not medical tourism!). I have been in close contact w/ emails and pics, and am using gauze changes twice a day with SilverStat. Not a smoker, healthy, no diabetes etc. I am a LPN(RN soon) and have limited knowledge of wound care. I know it's good it's bleeding a little and have been keeping it clean, moist and debriding the protein and visible sutures out. I am getting increasingly concerned about how fast the opening is growing!

Jeffrey A. Sweat, MD · Answer

I'm really sorry to hear that you are having problems after surgery.  My biggest concern is that you have an implant in place and if it becomes exposed with the deepening of the hole, the implant will by definition become infected and will have to be removed.  If at all possible, I think it would be best for you to go to see your plastic surgeon so he or she can see what's going on in person because if you were my patient, I would be very nervous about you potentially having complications and being so far away.  However, your plastic surgeon will know better about how the surgery was done and hopefully there is no cause for concern.  Best of luck in your continued recovery!

Jose M. Soler-Baillo, MD, MS · Answer

Thank you for your question and photos.  Please continue to maintain close contact with your operating surgeon during the wound healing process.  When the wound is healed, you can consider a scar revision procedure.All the best,Dr. ResultsMiami, FL

Amy T. Bandy, DO, FACS · Answer

I agree with Dr. Sweat; you need to be seen ASAP to get closure of this wound.  If this were a wound from a mastopexy or breast reduction without implants, there would be no hurry, but with implants, it is another story.  You may already have exposure to the implants, but if you do not, then debridement of the wound with secondary closure should be considered to try to salvage the implant.  If you cannot go see your original surgeon who is 8 hours away, you should look for someone close to you to be seen ASAP.  Good luck.

Jaime Caloca, Jr., MD · Answer

Opening of a Brest Lift Surgical wound is most commonly due to either skin tension, reduced blood flow or both. Your surgeon most probably indicated the best way to maintain the wound clean. Being almost an RN, you are familiar with wound care and will be able to follow your surgeon's instructions with the objective of limiting the extension of the opening and promoting wound healing. If the implant is not exposed, then you can avoid having to take it out. Usually this is the case and then once complete secondary healing is obtained, you can get scar revision in the future. Your physician may prescribe medications such as antibiotics to reduce the risk of infection and will decide if a surgical intervention under local or general anesthesia is necessary. Keep your surgeon updated with daily photos and a description of your progress and do notify him immediately if you see the implant itself. I wish you the best.

John L. Burns Jr., MD · Answer

Unfortunately would healing at the T zone can happen with breast lifts; especially if combined with augmentation which puts extra pressure on the skin.  Trying to close the area at this stage will not work so keep up the local wound care as prescribed by your surgeon.  After it has healed you may need a scar revision at a later date.

Tania Medina de Garcia, MD · Answer

Hello
dear, thanks for your question and provided information as well… 
I have to say that you are still early on healing process, it is too soon to
determine how your results are going to be, per now, they look very nice and
beautiful, you can have one bigger than the other, feel swollen and also have
bruises and open wounds, it is normal and that can happen for the first 3 to 4
months until your implants have settle in. I recommend you to wait and keep
using your post surgical bra, that will help you with the shape and support!!

Robert E. Zaworski, MD (retired) · Answer

Maintain close contact with your Plastic Surgeon.  You are at risk for an infection which would require implant removal.  Once the wound is healed, scar revision can be addressed at a later date.

17 days post op from a lift/aug(265cc implant) and worsening wound over the past week....when to worry? (photo)

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