Has my incision separated and become infected? Breast Aug 2 weeks post. (Photos)

Question

I had one breast reconstructed due to tubular deformity and that breast is causing alot of trouble. I sent these pictures to my surgeon as I am abroad on holiday for christmas, he told me to use antibiotics and antiseptic spray and to fly back to see him in the next week or two if there is no improvement. What is the white strip? Is it infected and will the infection spread to the implant pocket or is it superficial. The redness has gone down since yesterday and there is only occasional pain.

Richard H. Tholen, MD, FACS · Answer

You appear to have superficial (surface) wound separation, but the cause is uncertain, and something that cannot be determined solely by examination (or photo). That being said, the adjacent tissues do not look infected. However, wounds do not separate with "normal: healing, so antibiotic coverage is certainly prudent.The white strip is exposed dermis. Do not cleanse the wound with peroxide--this can further bleach the tissues, although peroxide is toxic to bacteria, it also kills healing cells. The trade-off is not good, IMHO, so this remedy (often recommended by physicians) should NOT be used. Simple cleansing with gentle soap and water, and application of Bacitracin (or antiseptic spray), is what should be done, as your surgeon has recommended. Here's another common fallacy: use of Neosporin or Mycitracin (triple) antibiotic ointment is NOT good, as 10% of the general population develops allergic hypersensitivity to the Neomycin antibiotic in triple antibiotic ointment. So single antibiotic ointment (Bacitracin) is actually better, and less likely to look like an infection when the triple antibiotic has stimulated a red, inflamed, hypersensitivity response with repeated use. Just saying. Peroxide and triple antibiotic ointment: sounds good, right? Well, actually, NO.There truly no way to tell if there has been any bacterial contamination of the incision, deeper tissues, or implant pocket. That's why antibiotic coverage is wise, as is taking things easy so there is no more mechanical damage to the weakened incisional healing. Time will tell, but this doesn't look too bad at this single snap-shot in time. See your surgeon ASAP and avoid excessive strain on your breast incisions. Best wishes! Dr. Tholen

Gregory Baum, MD · Answer

Based on your photos, you appear to have at least a superficial wound separation which should be monitored closely due to the potential for exposure of your implant. The "white" line in your wound is fibrin (human glue). It's not dangerous but is a marker that you have an open wound. Hopefully the wound will close on its own. It doesn't look infected so I don't think antibiotics are necessary. I would use Vaseline ointment and a dry dressing on the wound once daily but I would recommend speaking to your PS about what he/she prefers. Best wishes!

Emmanuel Mallol Cotes, MD · Answer

Thanks for the question. In my practice, after performing a BA I recommend to my patients to limit the movement of the arms for two weeks. After that, you can move your arms taking care and always with common sense. In this regard, it's not advisable to carry heavy weights to prevent the implant out of position, and allow the formation of the physiological capsule around the implant, also to avoid pain and breast swelling. Kind regards

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  I agree with your surgeon's advice.  If you develop worsening redness or fever, contact your surgeon immediately.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Aldo Guerra, MD · Answer

Thanks for sharing your photos. I believe you have a wound separation, but you need immediate evaluation by your plastic surgeon. Only they can determine how serious this separation will be in the future. Warmest regards, Dr. ALDO

Has my incision separated and become infected? Breast Aug 2 weeks post. (Photos)

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Has my incision separated and become infected? Breast Aug 2 weeks post. (Photos)

Answers (8)

Answer: Breast augmentation

Answer: Breast augmentation

Answer: Wound separation?

Answer: Wound separation?

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Everything you need to know about Tuberous Breast Correction Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.