7 weeks post op Breast Augmentation. Is it infected? What needs to be done? Is it normal? (photos)

Question

5weeks post op I noticed a small hole. I went to my Nurse and she dressed it cleaned it and said it was normal and that the end stitch has risen to the top and it would heal on it's own. 7weeks post op it's double in size, It is painful, and the dressing is regularly covered in a yellow/green smelly puss like substance. It hurts, it's red and I'm worried about the scar I will be left with as it's not closing? I love 3hours away from my PS and hospital so what should I do??

Thomas Trevisani, MD · Answer

At 7 wks post-op- I would expect the wound to be completely and totally healed. At this point I would seek opening of the wound and exploration with culture and sensitivity of the fluid inside of the pocket. You may be facing temporary explantation until the reason for the failure to heal is determined.

Martin Jugenburg, MD · Answer

Based on your description you may have an infection - from your photographs it appears to be a superficial wound and with local wound care it should resolve. Please ensure you seek an in person exam from your plastic surgeon since it is not getting better.

Scott W. Vann, MD, FACS · Answer

Seven weeks is late for most real infections around an implant. Your photo seems to show a small stitch issue that will likely be self limiting. We often close the last inside layer with a running suture and so the knot will be at the end of the incision. This knot is more likely to push out thru the incision and cause a small problem. See your surgeon for an exact diagnosis and treatment.

Jerome Edelstein, MD · Answer

Usual symptoms of bacterial infection include pain and tenderness, swelling, and erythema. Sometimes, there may also be a fever and purulent discharge (pus). Infection usually occurs within the first month (in two thirds of cases), the average being at the eleventh day mark. If your surgeon is already aware of your situation, then you are probably following a suitable course of treatment. However, you mentioned that you saw the nurse and not your surgeon. Please see your surgeon as it may well be an infection that should be treated as soon as possible. Best of luck.

Australia Fragoso-Baez, MD · Answer

your first picture shows a open stitch but your later description is not something that simple and as you say it is draining pus you should go and see your plastic surgeon, it doesnt sound like something troublesome but in order to easy your mind and get proper recommendations see your surgeon. Good luck!

Stephen M. Herring, MD, DDS · Answer

Suture exposure is not uncommon after surgery. In most circumstances such as these, the problem is self limiting and inconsequential. However, drainage from a wound, especially a wound through which a foreign body was placed (the breast implant), deserve close attention. If the "infection" is deeper, then more aggressive treatment may be indicated. The problem should be followed very closely until it is resolved. If any signs or symptoms of large localized or systemic infection occur, then you should seek care immediately. In some circumstances, lab studies can be helpful to confirm or rule out an infective process that needs aggressive care.In either event, the problem can be managed by your surgeon. Disclaimer: The most accurate medical advice requires a complete history and physical with a personal consultation. This is rendered only as general information and is not medical advice. Medical advice can only be obtained by personal contact with a qualified professional. This response does not establish a physician patient relationship.

Andrew Elkwood, MD, FACS · Answer

It looks like your incision line has opened up a little bit.  Not uncommon. If there is puss coming out and it smell bad you should see your surgeon, not just his nurse.  Keeping it clean and dry is the best bet until you can get to see him.  From your first picture it looks like there is a suture inside that should be removed and some drainage is normal from an open wound.  If you are experiencing fevers you should see your surgeon ASAP. Good luck

Robert H. Hunsaker, MD · Answer

Typically,if there is exposed suture material,it needs to be removed to get this to clean up and stay healed. From the description and the photos,itseems to be related to that rather than something deeper. BUT....you don't want it to get worse so try to see your doctor soon if it isnot improving.

Stanley G. Poulos, MD - Account Suspended · Answer

The most common cause of an open wound in the incision line is an extruding suture. This however is usually a self limitng process in that as soon as the suture "spits out" the wound heals. Occasionally this can become infected giving rise to symptoms such as spreading redness, hot tender skin or fever and chills. If this is the case you should notify your doctor and h=if you are out of his/her area the you should be seen in a local emergency room. Better safe than sorry. Good luck.

Thomas A. Cochran, Jr, MD (in memoriam) · Answer

Thanks for your question. I would absolutely advise you to return to your PS. You stated that this has doubled in size and now has foul smelling drainage, your surgeon needs to address this. Good luck to you.

7 weeks post op Breast Augmentation. Is it infected? What needs to be done? Is it normal? (photos)

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