Should I remove? (Photo)

I am not a smoker. Very healthy person. 4 weeks post op BL & BA & wounds won't heal. Doctor says they are not infected. I really want my implants but I don't see this turning out to be ok. He has sewed the openings twice but this time the opening is very large.. help :(

Doctor Answers 9

Wound Healing after Breast Surgery

This can be a significant problem in patients that smoke or have diabetes. If the skin is pulled very tight the skin may not survive as well. It looks like the top layer of skin has been lost however the implant does not seem to be exposed. Local wound care until this heals would be the best path unless the implant becomes exposed. Local wound care would consist of daily dressing changes with an antibiotic ointment (Bacitracin or Bactroban) and dressing over this to form a clean, closed wound until the wound has contracted and closed by secondary intention. Hyperbaric Oxygen therapy would improve the healing process. 1 1/2 hours per day for about 10 days. The healing process will take several weeks to complete. The scar could be revised later after at least 6 months. If the implant is exposed at any time it should be removed and the wound closed at the time of removal of the implant.

Bay Area Plastic Surgeon
4.9 out of 5 stars 14 reviews

Implant salvage

If there is a think layer of breast tissue your implant should be ok. Only your surgeon can answer that question. The breast will heal and I wouldn't remove the implant just because you have the open areas. Follow up closely with your surgeon.

Lee E. Corbett, MD
Louisville Plastic Surgeon
4.8 out of 5 stars 25 reviews

Wound healing problems after breast augmentation/lifting surgery.

  I am sorry to see/hear about the complication you are experiencing.  Your concern/anxiety are certainly understandable.  As you mentioned, much of the concern is regarding the underlying breast implant; your plastic surgeon will know how much tissue there is between the open wound and the underlying breast implant.  If there is a significant layer of tissue between the open wound and the breast implant, it is most likely that will go on to heal over the course of the next several weeks.  If there is minimal tissue present, the breast implant exposure (which would require breast implant removal) will likely result.   Everything considered, I would suggest that you follow your plastic surgeon's dressing changes regimen;  hopefully breast implant removal can be avoided. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Wound issue

This likely will heal with local wound care but it will take a while. It is important to follow closely with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Open wound

 In my experience, this will heal although slowly. In the past, when I've encountered this degree of open wound, we have used a product called a cell, which is a temporary skin graft that allows for more rapid regrowth of the outside layer of the skin. This may take a few weeks. Once everything has loosened up and it will with this large of an implant, then it's safe to go back and remove the area that has a very tenuous outside layer. Because everything so tight right now, trying to go back and reclose its generally does not work. Follow the instructions of your chosen plastic surgeon. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Should I remove?

Appears as implants were to large to allow the vertical incision to be closed with minimal tension. thus the dehiscence issues as seen in your posted photos. Best to remove implants at this stage

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Should I remove?

In cases like this, I allow the wound to heal with dressing changes. It takes some time and patience.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

Should I remove?

Hello dear, thanks for your question and provided information as well...I would recommend you to get a consultation with your surgeon, you should see your surgeon as soon as possible to get your wound cleaned, it is very important for you to have everything good, hugs!

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 417 reviews

Removing implants

Thank you for your question and I'm sorry that you're going through this.  Based on your picture it doesn't look like your wounds are infected but I can definitely see how they haven't healed.  I think that one of the reasons they didn't heal is that the implant that was put in appears to be large, and this can put a lot of stress on the tissue as it is trying to heal.  

There are a couple of options with this.  You can continue with taking care of the wounds and it is possible that they will heal on their own.  This will leave you with a widened scar but if all goes well you would be able to keep your implants.

Another option is to remove the implants, allow your skin to heal and to replace the implants (likely with a smaller size) down the road.  I know this isn't your favorite option, but it is one possible choice.

Dealing with complications is never fun and I hope you are able to get this taken care of,
Dr. Seth

Seth Eberlin, MD
Walnut Creek Plastic Surgeon
5.0 out of 5 stars 2 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.