Holes in the Incision! Any suggestions? (photos)

Question

Hello doctors, I'm 6 weeks post periareolar mastopexy. So far an unpleasant surprise every other days & don't know when this is going to stop & I can enjoy the result of my surgery w/o being so worry & conscious about it! Today I noticed there are some whitish pus on 2 spots on my areola incision in which I found a very tiny bit of left-over dissolvable stitch. When I cleaned them, these 2 hole appeared! I'm kind of worried. Please help. Also, will this cause bad future visible scars? Thank you

William Andrade, MD · Answer

Hello,  I would recommend contacting your surgeon to discuss your concerns.  A common cause of a small wound that appears along the incision is a stitch that comes to the surface and causes a small irritated pocket to occur.  Once the stitch falls out or dissolves away, the hole usually heals, and I find that in most cases the final result is not affected.  Your surgeon can do a proper assessment and confirm the cause, then recommend treatment.

Jerome Edelstein, MD · Answer

Hello,It is not uncommon to have a small opening take longer to close or to "spit" a stitch and these superficial openings are usually closed with conservative wound care. Ask your Plastic Surgeon to examine you as they may need to remove an irritating suture.All the best

Gerald Minniti, MD, FACS · Answer

Hello,You will need your periareolar suture removed, as it is infected and causing tissue breakdown.  Please return to your surgeon for removal sooner than later.Best of luck!

Gregory A. Wiener, MD, FACS · Answer

Hello, and thanks for the question and photo. This, unfortunately, is a common occurrence where the dermal layer (deeper layer of the skin) has been closed with absorbable sutures. Most plastic surgeons close incisions this way as it is a stronger closure and takes tension off of the outer layer (epidermis) and allows for a better scar. Quite often, however, the body may get rid of some of these sutures before they can fully dissolve and be absorbed. This usually happens when bacteria gain access to the underlying suture and create a small abscess that looks like a small pimple. The abscess eventually bursts, and the partially dissolved suture falls out leaving a small hole in the incision. The hole will usually close up within a few days and usually doesn't affect the quality of the scar. However, if multiple stitch abscesses occur within the same length of incision, there could be some eventual widening or thickening of the scar, but this is unusual. Use warm compresses if you see one of these forming. The faster it comes to a head and bursts, the less inflammation and potential scar problems will occur. Antibiotics usually won't help prevent these.Hope this helps!

Malcolm A. Lesavoy, MD, FACS · Answer

From the photo, it seems as if you are experiencing a reaction of the dissolving stitches under the skin that now is coming to the surface.  You just have to let it run its course, and use non-reactive stitches in your case the next time around.

Curtis Wong, MD · Answer

from sutures will heal, and most likely with inconspicuous scars.  Use good wound care and watch them heal.

Gary L. Ross, MBChB, FRCS · Answer

Wound issues such as this are not uncommon following the peri-areola incision and I would keep in touch with your PS. The key is that you don't develop an infection

Tal T. Roudner, MD, FACS · Answer

It appears you have a common issue of "spitting sutures" which are absorbable sutures that are rejected by the body. Wound care should help heal the wound speak to your surgeon about it. Long term it should heal well. If you are not satisfied later a small scar revision maybe needed.Good luck!

Luis A. Fernandez Goico, MD · Answer

Hello, Thanks for your question and photo. That is not so uncommon, and it should not leave any permanent damage. It is caused by the absorbable sutures, specially where there are knots which actually are a bigger accumulation of the thread. Don't stress about it, should be gone within a few days/one week. Happy healing, Dr. Fernandez Goico

Arian Mowlavi, MD, FACS (license on probation) · Answer

You are experiencing suture granulomas over your breasts; this is due to either: 1)your body not liking the suture being used: you should get the name of the suture so that u don't use it again; 2)poor suturing technique where the knot is placed too superficially; 3)too much tension on your incision line. Local wound care, removal of sutures trying to extrude are your best options to manage your problem; remember, that these sutures will be reabsorbed eventually and this timing is dependent on the suture used.

Holes in the Incision! Any suggestions? (photos)

Answers (10)

More Breast Augmentation Questions

Recovery time for subfascial implants?

I have a small dent in my muscle on my left breast, right by my sternum. Is this normal during the healing process?

Basic life support training after breast enlargement for nursing student. What could go wrong if I was to do compressions?

what make a breast augmentation look fake? do i like fake or natural? (photo)

Why do my new boobs look like this!?? (photos)

Is it normal to have (not sure how to describe it) tracheal area discomfort 2 weeks post op Breast augmentation?

WE SEND PRETTY
EMAILS