Will I need revision surgery, or will I heal on my own? (photo)

I am 12 days post op, has a prophylactic bilateral mastectomy with insertion of tissue expanders. Drains still in (2, 1 on each side). Right now plastic surgeon asked to clean with hot water using cotton in the mornings, applying polysporin and changing the dressing. This was yesterday and next appointment is on Tuesday. Photo shows right breast although left breast is in the same condition. I appreciate your advice.

Doctor Answers 4

Please be seen and examined by your surgeon!

We cannot assess the tissues through a photo.  It is important to be seen in follow up.  Mastectomy flap necrosis is an ongoing issue in breast surgery for cancer.

Will I need revision surgery, or will I heal on my own?

Appears to be skin edge necrosis due to poor vascular supply to flap edges. The issue is one of expander exposure...

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Wound complication following breast reconstruction

Although difficult to assess your wound by photo alone, it does appear that you have a wound of the area. At about 2 weeks postoperative, your surgeon may be waiting for this wound to fully demarcate before making a decision of what to do - continued local wound care or surgical debridement of necrotic skin/tissue. I am certain that your surgeon will discuss the options upon examination in person of the wound and make a decision of which path to take at that time. Certainly, if necrotic tissue is present, it certainly could cause infections; with a prosthetic and maybe dermal matrix beneath the skin flaps, these may become threatened if an infection ensues.

Thank you for the question - hope that this helps!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast reconstruction may require a revision

The picture you show does seem to show necrosis however pictures never replace an in-person assessment. Whether or not this is necrosis, there is nothing you can do to improve your outcome between now and Tuesday. Your plastic surgeon will see you on Tuesday and hopefully by then if there was any doubt about the prognosis for this reconstruction it will be clarified.
If you do need a revision you may have to have some fluid removed from your tissue expander to collapse it and allow the healthy skin to close as the suspicious looking area may require debridement.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 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.