A month post breast augmentation. Should I be worried about this or will this be ok? (photos)

Question

I asked my nurse if this is infected or maybe i need antibiotics for this but she has assured me it’ll close on its own.I do air fruit with a blow dryer on low after every shower, and when I’m done I tape gauze over it. She didn’t instruct me to apply any type of ointment so I haven’t been applying anything to it. I had 560cc to both my right and left breast. I hope it doesn’t have anything to do with the size ?

Eric Schaffer, MD, FACS · Answer

The incision should be examined by your plastic surgeon.  He/she may need to place an extra few stitches to help the incision with its integrity.  As for care of the wound and/or antibiotics this needs to be decided by your surgeon.  Good luck.

Michael Orseck, MD · Answer

I would consider cutting out the incision and reclosing it.Is there drainage?  If so what color is it?  Is there more tenderness of the breast on this side?  If so, infection may be present.  Best to get a second opinion if you are uncomfortable about the way it is being handled.

Nirmal Nathan, MD · Answer

You have breakdown at your surgical incision and need to be evaluated by your surgeon as soon as possible. He/she needs to make sure the implant is not exposed. If it isn't it can be managed with wound care and possibly closing it again. If the implant is exposed, you will need a much bigger surgery to washout the breast pocket and replace the implant. Good luck.

Farbod Esmailian, MD · Answer

Thanks for the photos and sorry to hear about the issue you are experiencing.  It is difficult to tell if this is going to be an issue in the near future.  A superficial dehiscence (separation) of the IMF incision would not be an issue, specially if the would was closed in multiple layers.  If it was not then this may become a problem.  The size of the implant may play a role in the problem you are having as the implant is pretty good size and does exert a decent about of pressure on the wound.Wounds tend to heal better in a moist environment (abx ointment) than a dry setting.  But I would recommend you discuss this with your plastic surgeon before doing anything to the wound.  Make certain you continue with your frequent follow ups.Hope that helps.

Aldo Guerra, MD · Answer

You need to see the doctor who placed your breast implants for an evaluation of your wound as soon as you can. It’s always worrisome when there’s a breast implant behind an open wound. Best wishes. Dr. Aldo

Daniel Barrett, MD · Answer

Dear mjaay13,it is hard to tell for sure without an examination. I would suggest you to consult your plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Pejman Aflaki, MD · Answer

Hello and thank you for the question. You should see your surgeon for an evaluation. It's unclear if this is just a superficial breakdown or if it communicates with the implant cavity. Regardless, you should have frequent and regular follow ups with your surgeon. If this is superficial, it should heal spontaneously with no major scarring issue. I would keep the area clean and avoid any strenuous activity/lifting, smoking (if you are a smoker), underwire bras or anything that places excess tension on the incision. Best,Pejman Aflaki, M.D.Johns Hopkins-trained plastic surgeon

William Andrade, MD · Answer

Thanks for your question.  It's not possible to know if this is a minor superficial wound or something that is deeper based on your description and photo.  It's important to have ongoing assessments and followup with your surgeon if there is a wound healing issue after breast augmentation surgery.

Lavinia K. Chong, MD · Answer

Listen to your intuition.  Separation of an inframammary fold scar can occur because of suture failure, excess tension on the breast skin envelope because of the size of the implant.  Whenever the skin fails to heal by primary (edge to edge) intention, the possibility of infection increases.  Wound infections can be treated with antibiotics, however there is a correlation also with higher rates of capsular contracture; neither of which you want.  So insist you see your PS to get a plan of care.

Tim Sayed, MD, MBA, FACS · Answer

You need to be seen ASAP by the surgeon directly. Any amount of delayed healing/wound opening is concerning if there are breast implants present. The wound can permit a conduit for bacteria to reach your implant, so debridement and reclosure in a sterile environment may be necessary. While most surgeons close the incision in multiple layers, large implants put added weight on the inframammary wound as it is healing, and there is often thinned out tissue in the lower pole at the incision level. Open breast augmentation wounds should be taken very seriously by the patient and surgeon and monitored/managed closely. If you have pain, redness, additional swelling or drainage, those could be signs of infection threatening the implant. If the breakdown is only very superficial, the wound might close on its own in a reasonable timeframe, but clean wound care is important and antibiotics might be appropriate as a precaution. See your surgeon and good luck!

A month post breast augmentation. Should I be worried about this or will this be ok? (photos)

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