Advice on wound care? (photos)

11 days PO from breastlift+aug there was drainage from under my steri strips, removed them as per instruction of Dr and found this (photo) instructed to soak & clean with alcohol then cover with gauze. Keep clean & dry and it will heal. 36 hrs later, still draining some straw colored fluid, sometimes slightly pink. It has no foul odor, does not hurt anymore than normal. Does the white tissue need to be removed, will it heal if it's not? Seeking 2nd opinion, I am in contact with my surgeon

Doctor Answers 3

Wound care after breast lift plus implants.

The areas of the inverted-T breast flap closure is where circulation is at a minimum, and areas that can break down more easily than suture lines closer to excellent blood flow. Basically, this can happen with any lift where skin flaps are elevated from the underlying tissues and blood flow is received only from the subdermal capillaries. This is also why surgeons tell their patients that smoking or tobacco use (including nicotine products of any kind, e-cigs, or even second-hand smoke) can cause circulation impairment and lead to a higher risk of wound breakdown or even dead skin.

Soaking these wound with alcohol (or peroxide) is NOT advised. These powerful agents kill germs to be sure, but this is a circulation problem, not an infection problem (at least at this time--but more about that in a minute). Both alcohol and peroxide also kill normal skin cells, which is why I think your area of "white tissue" (this is dermis, and, NO, it should NOT be removed--this is all that is holding things together at this time) has enlarged: the skin cells on the surface of your wounds are already "hurting" for adequate blood flow, and then you are putting strong fluids on these tissues that have killed additional surface cells.

The gentlest of soaps and water washes (without soaking and softening already-weaker tissues), plus a thin layer of Bacitracin, and a non-stick dressing are all that are needed for wound care, plus an oral antibiotic so that these open wounds do not become infected. Patients often think that prescribed antibiotics mean "infection," but in this setting they are recommended to minimize the risk of infection developing in small wounds that will heal if just protected and with no further harm done by overzealous treatment.

Steri-strips are not recommended, though they are tempting to "reinforce" wounds that may be under some tension still, and that have increased potential for additional breakdown. The problem is that doing "too much" can actually increase the chances of developing the very problem you and your surgeon both want to avoid--this area "falling apart" on one or both sides.

I cannot stress enough that these tissues are in a tenuous situation, so doing the "right" things and avoiding potentially harmful things like alcohol soaks are critical to healing without further problem. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Advice on wound care?

I have to say that you are still early on healing process, it is too soon to determine how your results are going to be, per now, they look very nice and beautiful, you can have one bigger than the other, it is normal and that can happen for the first 3 months until your implants have settle in. Open wounds and scars are also very common in this procedure, and also if it happens, you have to get with your plastic surgeon for cleaned and if it's worse , put stitches on it.I recommend you to wait and keep using your post surgical bra, that will help you with the shape and support… 

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 396 reviews

Local Wound Care

You don't have an infection yet and your situation is salvageable if the right things are done.  You should be wearing a bra 24/7 and doing dressing changes two to three times daily.  You should also be on oral antibiotics to prevent any infection from developing.  Finally, I would recommend Steri-stripes on the portion of the incisions that are still closed to take more tension off of the area that is open (in addition to wearing a post-surgecal bra).  Close supervision by you surgeon is essential at this point so that you end up with the result you desire.  

Eric Sadeh, MD
Manhattan Plastic Surgeon
4.2 out of 5 stars 57 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.