I have wound breakdown after Breast Lift with Implants. Is this normal? Is there anything I can do to help the healing? (photos)

I had a breast uplift with implants 2.5 weeks ago, I had excessive wound fluid and when the dressings were taken off I had slight wound breakdown. The wound is getting bigger and more discharge, my surgeon said to keep clean and just put gauze in my bra which I am doing, but I have to change at least twice a day and the gauze sticks to my wound and when removes causes it to bleed. How long will this take to heal, is there anything I can do to help it along?

Doctor Answers 8

Sorry you are having some trouble healing.

Hello Michelle 1983, 
Sorry you are having some healing difficulty. Unfortunately the T intersection of this type incision is often a trouble spot since that is a point of tension and there are two crossing scars. These small areas of necrosis will usually heal on their own with just local wound care (dressings as you are using). I would follow what your surgeon is suggesting although you may want to ask him/her about using antibiotic ointment (neosporin or polysporin) and a non-stick gauze (telfa). As far as timing on healing it depends on how wide and deep the area of compromised healing is, from your picture I would estimate ~3-4 weeks. 

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 5 reviews

Wound following

Breast augmentation with mastopexies not uncommonly can have delayed healing. This occurs because of the tension located at the junction of all the incisions. Treatment is usually conservative with dressing changes and wound care. Antibiotic ointments are general helpful. You should expect several weeks of drainage and mild bleeding before the wound heals. In most cases, healing occurs without much scarring. Be sure to see your doctor frequently if you have any questions.

Robert M. Wald, Jr., MD
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Wound Breakdown Following Breast Augmentation & Lift

Your pictures demonstrate wound separation along both the transverse and vertical limbs of your breast closure. Unfortunately, wound separations aren't unusual following this type of procedure for a variety of reasons.

When patients undergo breast augmentation in combination with breast lift surgery, skin flaps are wrapped around a central pedicle of breast tissue that supports the blood supply to the nipple areola complex. The area where the transverse incision meets the vertical incision is at significant risk for breakdown because the flaps in this location may have poor blood supply. In addition, the weight of the pedicle and breast implant may exert significant downward force upon the closure where it's weakest because of poor blood supply.

Wound separation following this type of procedure usually heals nicely with local wound care and dressing changes. It's not unusual for minor bleeding to occur with dressing changes as debris is removed from the wound surface. In most cases, healing is complete in 4 to 6 weeks, but this may vary from patient to patient. In a small number of cases secondary scar revision may be necessary at a later date.

Even when patients who undergo the combination of breast augmentation and breast lift have areas of wound separation, the clinical results following this procedure are excellent. After wound healing is complete levels of patient satisfaction are high as well.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

have wound breakdown after Breast Lift with Implants. Is this normal? Is there anything I can do to help the healing

Thank you for sending your question and photo. Your closure has slightly opened. Separation in this area can occur with breast lift and implant surgery. Cleanse and apply antibacterial ointment. Wash hands prior to application.  Healing varies from 1- 6 weeks  Please contact your Plastic Surgeon to be seen today for further recommendation.

Jeff Angobaldo, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 104 reviews

Breast Lift with Implants

Hi Michelle,

The area where you have a breakdown is the exact area of this surgery which has the least blood supply.  So it is not uncommon to see skin breakdown in this area.  Keep your surgeon in the loop, be seen frequently, and follow his/her instructions to the letter to aid this to heal in.  Yes, there is lot you can do to help it along.  It might take a month or so to seal over.  All the best, "Dr. Joe"

Joe Gryskiewicz, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 269 reviews

Wound healing difficulties after breast lift plus implants.

Wound breakdowns like yours are not uncommon following this surgery, and they almost always look worse than they end up. In other words, they look large and terrible at first, but with proper management, go on to heal quite well. In fact, they actually heal so well most women choose not to undergo scar revision, though those same women look at the wound at this stage and think for sure they will need scar revision.

Sticking to dead scabbing and causing bleeding is NOT a bad thing--healthy tissue bleeds and dead skin and scabbing does not! Blood has healing factors that actually accelerate healing, so do not be afraid to pull of those gauze dressings, and don't soak them off gently and leave that garbage on the wound surface! Honest!

The only concern is that you say the wound are getting bigger. If indeed this is the case, then you should be seen by your surgeon, Though your photograph shows no evidence of infection, without doubt your tissues are compromised as they heal, and an oral antibiotic may be reasonable. Ask your surgeon when you see him/her.

This should continue to heal, but only if it is getting proper care and management. It will take several weeks to completely seal shut, and longer to soften and mature fully. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Wound healing delay after breast augmentation with lift

Wound breakdowns like you have are common after breast lift with implants.  Based on your history it sounds as though your plastic surgeon is managing your wound properly.  Very generally speaking with proper cleansing, removal of dead tissue, and a clean red wound, skin healing takes 6-8 weeks for completion.  However it is very important that you follow with your plastic surgeon at least every week to make certain that there is adequate coverage of your breast implant.

Wound therapy

Wound healing delays/"breakdown" are unfortunately not uncommon from the stresses applied following breast lift with implants. For now, keep following your surgeons advice until your open wounds are completely closed with scar tissue. 
You may then benefit from one of the new forms of topical scar therapy, see below:
Not infrequently potential patients avoid surgery because fear of an unsightly scar. To remedy this, I now utilize and formulate compounded topical creams to treat, relieve and minimize scars for each of my patients:
• new scars
• old scars
• surgical scars
• keloid scars
• stretch marks
• hypertrophic scars
• hyperpigmented (dark) scars
• various acne scars, burn scars and more...
These scar removal creams contain prescription strength medications each individually known to reduce and/or reverse the scarring process but never before compounded together into one high potency formulation. These medications are added to a base of anhydrous silicone (the most common ingredient in everyday topical scar therapy) and Pracaxi oil, found in the Amazon rainforest and known for its anti-inflammatory, antioxidant, antibacterial, and antifungal properties. Many health insurance plans actually cover the cost of the creams and they can be delivered directly to the patients door step. In other words, no need for multiple trips to the doctor for expensive and painful laser treatments, or wasted money on minimally effective over-the-counter topical scar therapy gels or silicone sheets that are unsightly and/or fail to stay on. Instead, with just two applications a day my patients now perform scar therapy in the comfort of their own home. Glad to help.

Ryan Stanton, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 117 reviews

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.