Is it normal to have delayed bruising after latissimus dorsi flap breast surgery?

Question

Four weeks ago I had a latissimus dorsi flap surgery placed along with tissue expanders. 6-8 months prior to that I had a double mastectomy/radiation due to left breast cancer. Few days ago I noticed a little redness spreading around the back incision site looking like a start of a bruise. Also, noticing a little change in redness and little purple around the left side tissue expander. I had my first fill about 2 weeks ago. I wasn't sure if that is normal to have delayed bruising after surgery.

Jeffrey A. Sweat, MD · Answer

I would suggest that you call your doctor's office and ask for an appointment to be seen.  In the presence of previous radiation, infection problems can be more common but redness without infection can also be more common.  You haven't mentioned anything about symptoms of pain, fever or chills but in the face of previous radiation and now an implant, I would suggest being abundantly cautious and making sure that your surgeon knows what's going on.  Best of luck!

Ryan Rebowe, MD · Answer

Delayed bruising is a common part of any procedure, and this is especially true of a latissimus flap where there is a fair amount of dead space from the flap harvest and transfer. However, it could also be a sign of a hematoma or other fluid collection, therefore I would recommend making your treating surgeon aware and having him or her check it out specifically.

Allen Gabriel, MD, FACS · Answer

Thank you for the question.  The LD flap is a great and powerful tool in reconstructive surgery.  The changes that you are describing can happen but would follow up with your plastic surgeon to make sure you don't have a fluid collection on your back.  Best of luck.

Paul J. Leahy, MD · Answer

I use the LD flap and tissue expanders quite often in my practice for breast reconstruction in the setting of prior radiation treatment. It can really be a great operation. I have seen this late development of skin discoloration or bruising as well. I believe it may have more to do with the healing of this incision on the back where there is a fair degree of tension on it. It's possible that you developed a very small bleed there during the recovery phase, and just now seeing the result of that. It's worth showing to your surgeon.Best of luck on your journey!

John M. Weeter, MD (retired) · Answer

The LD flap reconstruction with tissue expanders is a very good operation.  The new development of some redness  in the donor area of the back should be evaluated by your surgeon.  Any new redness after adding fluid to a tissue expander should be evaluated as soon as possible by a follow-up visit.  This may require antibiotics.  Between now and your follow-up visit it may be useful to have a record of several body temperature recording to help the surgeon determine if infection is starting.  Good luck.

Alfonso Oliva, MD, FACS (retired) · Answer

It is a bit unusual to have delayed bruising a month after surgery, but it can occur. If the redness is new, I would advise you to have this evaluated by your surgeon.  He would know if this is routine postoperative bruising or if this represents a possible cellulitis which would require antibiotics.  Your surgeon will be able to evaluate this quickly.

Is it normal to have delayed bruising after latissimus dorsi flap breast surgery?

Answers (6)

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