Is a Skin Graft Necessary for a Breast Reduction Gone Wrong? (photo)

Question

I had a breast reduction 6 weeks ago. At my one week f/u appt. I had a good size blister form under my right breast. I started using Bactroban but it increased in size. At 3 weeks I had my stitches removed which allowed the blister to completely open and spread. I have no skin from the bottom of my nipple down to my incision and nearly 7 inches across. It is extremely painful and my doctor said he has never seen this in his 31 years of practice. It is extremely painful!!!!

Jonathan Weiler, MD · Answer

You to have a very frank discussion with your PS, it can be healed with a Skin graft but this will leave additional scarring in other areas and will need to be revised, or if you chose you can allow it to heal on its own...good luck

Darryl J. Blinski, MD · Answer

Though rare this is a complication following breast reduction of wound dehiscence and necrosis. Options are allow healing by secondary intention which could take 3 months. or try a surgery of a STSG (split thickness skin graft). Both will leave a scar deformity, sorry.

Jeffrey Zwiren, MD · Answer

Just an unfortunate complication of a breast reduction. The blood supply to the breast is very predictable at the base of the breast but as you move out toward the end of the breast it is more and more random. Your early blistering was the first sign of vascular compromise. At this point there is no way to speed up the process. Treat with Silvadene cream, allow it to heal then may need a revision in the future.

Robert L. Kraft, MD, FACS · Answer

The breasts should be treated with good local care and debridement by your plastic surgeon, if indicated. They will go on to heal by secondary intention. It may take some time but should happen. At that point, you can evaluate the result and determine whether any revisional surgery will be required.

Benjamin Chu, MD, FACS · Answer

First you can not be too active as a lot of movement will further open the wound. Second you should put silvadene and not bactroban on the open wound. Do not let the open areas dry out as dessication will further deepen the wound. With time the wound will contract and the defect will become smaller. Looking at the size of the defect this may take up to three months of Silvadene usage. If you smoke then stop. Your other scars look hypertrophic. The use of the scar dressing Embrace will remove some tension of the breast reduction scars on the left breast and this may help the quality of your scars down the line. Eventually after the wound closes you will need a scar revision.

William B. Rosenblatt, MD · Answer

You would be surprised  how well it will look if you let it heal on its own. It will take a while, but with local care and a lot of patience it will heal up. Sometimes these things happen.

Is a Skin Graft Necessary for a Breast Reduction Gone Wrong? (photo)

Answers (7)