What else can I do to help my stitches that separated heal? (Photo)

I had my tummy tuck, breast lift with silicone implants 9/12/14. I saw my PS last Thursday and he said the seperation under my breast would heal and to keep it covered and dry. The seperation occurred about 2 weeks ago and seems worse now and I'm scared. Help

Doctor Answers 4

Partial skin separation at junction of skin flaps after breast lift plus implants.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
This is an area of incisional breakdown due to inadequate circulation at the tip of your skin flaps. This can occur in any patient undergoing this surgery, but is rare (<1% overall, but as high as 15-10% in smokers or those exposed to second-hand smoke--yup, even one cigarette). But even in non-smokers this can occur, and your surgeon has seen this before and is telling you the absolute truth, as scary as it looks now.

With a scab in place "holding things together," it's not quite as large or scary, but as the scab separates and the healing tissues stretch, the wound can look temporarily larger. Your photos show no obvious evidence of infection or other concern, and the final healed result will contract, fill-in, and be remarkably better than you probably are imagining right now! Honest!

Those of us who do lots of these surgeries see this occasionally, and know how to care for this. Your surgeon seems like he does too! Don't be scared, but stay in close contact with your surgeon and report any signs that might be interpreted as "worsening." This will ultimately be fine, and the scars can be revised once they soften and become mature (6-12 months) if you and your surgeon decide to do this. Fortunately, many who have this problem ultimately heal so well they choose to do nothing. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Separation after breast lift with implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
As scary as the wound may look, it should heal as long as the implant is not exposed. There are several local wound regimens that you should consult with your doctor about.  It may take several weeks. Hang in there!

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

Breast Lift and Open Wound

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
See your plastic surgeon again since you think your wound is getting worse. He/she may discuss a different wound care regimen that might involve dressing changes with an ointment or a cream, such as Silvadene. If he/she took a photo at your last visit, he/she could compare the difference in how the wound looks.

Best of luck. 

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 33 reviews

Wound Breakdown After Breast Augmentation with Lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Wound breakdown isn't unusual when patients undergo the combination of breast augmentation and breast lift surgery. This typically occurs where the vertical limb meets the transverse incision. It occurs for a variety of reasons and includes poor blood supply, tension on the closure and infection.

This type of wound is usually managed with dressing changes. Dressing changes remove debris from the wound surface and allow the wound healing process to continue. Rarely antibiotics are indicated when infection is present as well.

The vast majority of these wounds heal nicely, but rarely scar revisions are necessary. In the interim, it's important to maintain good communication with your plastic surgeon. Your surgeon should be able to get you through this difficult experience.

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.