Will this incision separation with slough heal well or do I need debridement? (Photos)

Question

I am 23 days p/o. 4 days ago my vertical incision started to split. I went right in to my PS. He has me using triple antibiotic ointment with gauze twice a day. My concern is the amount of slough. I asked him and he said to keep doing what I’m doing. Will the wound heal without removing the slough? Note, I do not smoke, I am in regular contact with my PS, and I am following his instructions.

Matthew J. Nykiel, MD · Answer

Hello and Great Question. I appreciate the time you are spending researching this procedure. My name is Dr. Matthew J. Nykiel. I am a Board Certified Plastic Surgeon, a Fellowship Trained Cosmetic Surgeon, and a Cosmetic Breast Augmentation Specialist.
This type of wound is not uncommon after breast lift. It is usually caused by poor blood flow.  It can take few weeks or months for wound to fully heal but I would suggest to continue following your surgeons instructions.
I hope that helps! Best of Luck! 
Matthew J. Nykiel, MD #CoreAesthetic Breast Augmentation Specialist Board Certified Plastic Surgeon

Eric Wright, MD · Answer

Based upon your photos, this appears to be limited to a small area.  This type of delayed healing is occasionally seen.  I would not recommend any debridement.  Follow your plastic surgeon's instructions and I anticipate you will heal in the coming 1-2 weeks. Good luck with your ongoing recovery.Dr. Eric J. Wright

Daniel Barrett, MD · Answer

Dear Luminous4916,
this type of wound is not uncommon after breast lift. 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

Jeffrey Thaxton, MD FACS · Answer

Thank you for the question and photos.  I think the advice your plastic surgeon is giving is very reasonable.  These wounds should heal in a few weeks and the scars should be fine.  Keep following your plastic surgeons advice.

Ben Brown, MD (license emergency restriction) · Answer

Hello Luminous4916,
Thank you for sharing your experience. I'm sorry to hear that your postoperative course has hit this roadbump. 
Assuming you are otherwise healthy and knowing that you are a nonsmoker, it is very likely that your wound will eventually heal with regular dressing changes. Changing your dressing is a form of mechanical debridement - slough and exudates from the wound will be pulled off with every dressing change as your body breaks down and degrades necrotic tissue during scar formation. It may take a few more days to weeks, but you should begin to see improvement in the base of the wound with regular wound care. Continue to follow up with your surgeon, as you have been!

Will this incision separation with slough heal well or do I need debridement? (Photos)

Answers (5)