How should I treat leaking at breast reconstruction incision site?

Question

2 months after breast reconstruction surgery my left breast had a pin size hole in the incision and was leaking pus. the doctor put me on antibiotics. but a few days later it started again. this time with mild pain as well.

Lewis Albert Andres, MD · Answer

Thank you for your question!  Your description definitely sounds concerning and should be brought to the attention of your surgeon for evaluation and examination.  At 2 months postoperative, your incisions should be healed and not having issues such as that you describe.  The most worrisome issue is an infection.   Your description and presence of pain lead me to believe that there is an ongoing infection.  If oral antibiotics have failed to resolve the issue, you are possibly on the path for salvage of the implants.  If truly an infection, your surgeon may consider IV antibiotics or exchange of your tissue expander along with irrigation and debridement of the area.  If still having issues beyond that, unfortunately, removal of the tissue expander may be required.  Follow-ups closely with your surgeon and follow all of the instructions.  Hope that this helps!  Best wishes!

Adam Bryce Weinfeld, MD · Answer

This sounds like a problem, especially if this was a tissue expander/implant based reconstruction.  Discuss this with your surgeon now.

Luis Macias, MD, FACS · Answer

It is difficult to comment without additional information. Was your reconstruction performed using implants or expanders or with your own tissue.  This is an important question because foreign bodies like implants do not tolerate infections well if they get infected.  Photos would also be helpful in answering you question better.

Robert Whitfield, MD · Answer

There are options including ultrasound which can evaluate the amount of fluid and where it is in relationship to the implant.

Jeremy Pyle, MD · Answer

What you describe is something that, as a surgeon who does breast reconstruction, is really hard to hear and not think the worst.  Specifically, a leakage at the incision can mean a fluid collection has worked its way out.  Typically, if it causes a hole like you describe, that fluid collection has bacteria. Even without an infection, low levels of bacteria around an implant can mean a great challenge to reconstruction and, possibly, loss of the implant.  Salvage efforts can sometimes prevent loss of your progress.  It's a challenging problem for sure.Best,Dr. Pyle

How should I treat leaking at breast reconstruction incision site?

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