I have necrosis of my nipples, and using only Silvadene. Am I going to lose my implants? Should I get a 2nd opinion? (photos)

Question

I'm 17 days PO after BA with HP 750 cc implants, under the muscle with lift. My PS says to keep applying Silvadene, and that the blackness will eventually scab and fall off but is fixable. But what about the blackness underneath too? My PS says that nothing looks infected or open though. My implants are under the muscles so I shouldn't be at high risk should I? Should I get a second opinion? I'm worried that we need to be more aggressive so that I don't lose my implants.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. I am truly sorry to see this outcome and this is very unfortunate. Once the necrosis has taken place and the tissues have died, there is not much that can be done other than allowing the wounds to heal and dealing with the outcomes and scars that result.From previous posts, I am going to make some assumptions which may or may not be correct, so feel free to comment. It appears from previous posts that you have chosen to travel out of the country for your cosmetic surgery. If so, then I hope you share this experience as a cautionary tale to others who are considering the same route. You likely live very close to several plastic surgeons who are board certified by the American Board of Plastic Surgeons and could have provided you with a safe and effective surgical outcome. Would it have prevented your current situation? Maybe or maybe not. But I would be willing to bet that the risk factors leading to this outcome would have been discussed and possible avoided under the guidance of an appropriately trained plastic surgeon. It is heart-breaking to me when I see patients subject themselves to sub-standard care and take great risk to themselves in terms of both safety and aesthetic outcomes....all in the interest of saving a few bucks. I honestly wish you the best of luck and hope things go well...

Tom J. Pousti, MD · Answer

I am sorry to hear about the complication you are experiencing.  Your concerns/worry are certainly understandable. Assuming you are working with an experienced board certified plastic surgeon, I do not think that a second opinion  will be helpful. In situations like this, I think that  "more aggressive" treatment is not necessarily helpful.  In my opinion, key will be close/frequent follow-up with your plastic surgeon who will be in the best position to follow you for signs of infection etc.  If no signs of infection or incision line separation occur, allowing your body to heal (without surgical intervention such as removal of the necrotic skin) may be in your best interest.  Although not pretty to look at, the dark tissue is serving as a "biological band aid"; again, hopefully the underlying tissues are healthy and the breast implants themselves are covered with a significant amount of tissue.  In regards to the potential for implant exposure, I would be most concerned about the area around the T junction.  It is hard to know how much healthy tissue exists between the breast implants and the overlying incision line. Besides close followup with your plastic surgeon, I would suggest careful attention to good nutrition (including a good protein source)  and avoidance of any exposure to nicotine products. Best wishes for an outcome that you will be pleased with longer-term.

Curtis Wong, MD · Answer

and it truly is every patient and surgeon's nightmare... but if your surgeon is board certified, there is nothing else to really do at this point.  It helps that your implants are under the muscle but it doesn't guarantee any outcome.  Let your surgeon guide you through your recovery from this and keep hoping for the best and that all of the damage is superficial and not deep.  Time will allow for that to happen and to determine the status of your implants.  Silvadene is certainly a good antibiotic to be using and you should be having frequent visits with your surgeon as at some point, the scabs may be debrided to facilitate healing.

I have necrosis of my nipples, and using only Silvadene. Am I going to lose my implants? Should I get a 2nd opinion? (photos)

Answers (3)

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Everything you need to know about Breast Lift with Implants

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I have necrosis of my nipples, and using only Silvadene. Am I going to lose my implants? Should I get a 2nd opinion? (photos)

Answers (3)

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Everything you need to know about Breast Lift with Implants

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