Is this breast tissue necrosis or just a scab? (photo)

The amount skin loss in the picture is substantial. Nevertheless, with careful wound treatment this should heal over time. I would guess that the area would benefit from a scar revision would is completely healed.

Clearly, this is an eschar of tissue necrosis.  The best way to handle it is to keep it clean.  This complication usually heals without additional treatment needed.

It does appear that you have some skin necrosis present.  The area at the "T" in a breast lift is not an uncommon area for this to happen as it has the greatest risk to the blood supply to the skin.  The good news is that, even fairly large areas of skin necrosis in this area will often heal up without requiring any further treatment.  It just takes awhile.  Sometimes the bad area can be removed under local anesthesia in the office, however, as long as it does not become infected, I imagine your doctor will treat it conservatively like any other "scab."  Eventually, it will fall off as the tissue underneath heals and shrinks.  If the resulting scar is not satisfactory, it can usually be revised under local anesthesia in the office.

Hello there

In the absence of infection there is no urgency to intervene and the area can be observed . The human body has a remarkable ability to heal itself and you may well be surprised at how well this area resolves .

It does take time , however .

Keep the appointment your plastic surgeon has made for you but let him know sooner if the area becomes red and painful .

All the best

Terrence Scamp

Yes, it is not unusual to see delayed wound healing or skin necrosis after these types of procedures.  The important point is how to manage this down the road.  There is a HUGE difference if this represents an implant case or not.  Patients having undergone a Breast Lift or Breast Reduction without implants can be managed very conservatively without much concern for the depth of the wound, time to complete healing, or to some extent the exact "status" of the wound.  These will heal eventually, perhaps with the need for a revision in the office under local anesthesia.

More critically, if an implant is in place, the status of the wound is of paramount importance as infection into the tissues or exposure of the implant can mean significant risk to the prothesis and even potential loss of the breast implant.  My suggestion is followup with your plastic surgeon who is aware of YOUR specific situation. Best of luck.