Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy will help this heal faster.A lift with an implant is controversial for two reasons. First, when you perform a lift you are making everything tight and closing the wounds under tension. It you add the expansive forces of the implant at the same time, you are fighting against yourself. There are forces on the wound which try to make them separate, which results in wider, thicker, more irregular scars. In the worst case, the wounds will open. So compromises are usually made in the operating room by the surgeon because they cannot close the lift wounds over the appropriate sized implant. Either less of a lift is performed so that the skin is not as tight and therefore there is less tension on the closure. Or a smaller implant than would be appropriate is used so as to decrease the expansive forces. Either way, you are compromising the aesthetic outcome. Often the outcome is so compromised that a second revision surgery is required. If however, you plan to have the lift first and then the augmentation after everything has healed, then you have two operation that are planned, both with much lower risk than the combined mastopexy/augmenation. The outcomes of the two meticulously planned operations are much better and a more aesthetically pleasing, and a safer outcome is achieved.
The second reason the combination of mastopexy and augmentation is controversial is because of the risk of nipple necrosis (death of the nipple). By making the skin tight for the lift, you are putting external pressure on the veins that supply the nipple. By putting an expansive force on the undersurface of the breast with an implant, you are putting pressure on the thin walled veins that supply the nipple. If the pressure by squeezing the veins between the implant and the skin is greater than the venous pressure in the veins, the flow will stop. If the venous outflow stops, the arterial inflow is stopped. If the arterial inflow is stopped, there is no oxygen for the healing wounds and the tissue dies.
Placing the implant on top of the muscle in combination with a lift puts the blood supply to the nipple at a much higher risk because in addition to the issue of pressure on the veins, you have to divide the blood vessels that are traveling from the pectoralis muscle directly into the breast (and to the nipple) in order to place the implant between the breast tissue and the muscle. This adds a third element of risk to an already risky operation. Mastopexy/augmenation with sub glandular implant placement is by far the riskiest way to address your anatomic question.
Thank you for your question and photos. I am sorry to hear about your difficulty with this incision. This is a common area for delayed wound closure. Typically, conservative wound care/cleaning and regular follow ups as you are doing, will help you to heal well with no long term issues. I recommend that you continue to follow up in person with your Plastic Surgeon and report any changes.
All the best
Wound care following surgery
Thank you for your question.I am glad to hear that you are being seen frequently as some surgeons would try to avoid the issue. This is a common area of some skin breakdown and is best managed with simple wound care. Every surgeon has their own preferred method. The area typically will heal with very acceptable results and rarely requires a little excision under local after fully healed.Best Dr. L
Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision
I appreciate your question.
I would recommend that you discuss this question with your surgeon as every surgeon has their own respective post op protocol for his/her patients. Your surgeon is your best resource as he/she is most familiar with your medical history and how you are healing at this time.
The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.
Best of luck!
Board Certified Plastic Surgeon
Optimal Healing After Breast Surgery
Hello and thank you for your question. I'm sorry that you're having these issues after your breast surgery! It looks as though you have a small, superficial wound in a very common place after either having a breast reduction or a breast augmentation with a lift (mastopexy). I would have you shower at least twice a day and allow warm, soapy water to run over the wound. Pat the wound dry and apply a small amount of triple antibiotic ointment over the wound. Cover the wound with a sterile, non-adherent dressing such as a Telfa Pad with an adhesive border. I would also make sure that you are on a multivitamin with zinc, and I would have you taking extra Vitamin C. Zinc and Vitamin C have been shown in studies to help with wound healing. I hope that helps, and good luck!
Wound after surgery
this is a common area of skin/wound breakdown after surgery. Discuss with your surgeon his/her preferred method of wound care, but typically some simple wound care will allow the area to heal without any major issues.