Had A Double Mastectomy April 10th, and Have To Go In To Have Dead Skin Cells Removed. Is This Common?

I am 34 and had a double mastectomy April 10th and have to go in tomorrow to have dead skin removed. Is this common? Also, will the skin be fine once the dead area is removed?

Doctor Answers 5

Preventable causes of dead mastectomy skin - What you can control

Once skin has died after mastectomy, nothing can be done to make it live again. If it is a small area, sometimes it can slough off as a scab and the surrounding skin can heal in the area. If it is a larger area, or if there is artificial material present that could be exposed, then removal of the area with surgery and coverage with living tissue is necessary. Otherwise, the reconstruction could be at risk. All is not lost, and this is not an unheard of situation. Most plastic and general surgeons have encountered this at some point to whatever degree. But, for those who have yet to have surgery and want the optimal healing experience - what can be done to keep blood flow to the tissue and prevent it from dying? What makes this a risky operation is when patients have medical conditions that prevent optimal blood flow to begin with - smoking, prior exposure to radiation, diabetes, and obesity can cripple existing blood vessels and prevent blood getting to tissues we that were necessarily injured with surgery. Talking with your doctor if you have any of these conditions and making sure you address them is what you can do for optimal healing. The next part is a little trickier: the way the general surgeon handles your tissue and the respect that is given to preserve blood supply is the other key factor in this process. The plastic surgeons are usually very kind when addressing this problem, but what they have a hard time saying is that the General Surgeon who removes the tissue has much more influence over the final healing than the plastic surgeon who is there to fill things back up. I can say this because I am one of those General Surgeons who performs the breast tissue removal, and then lets the plastic surgeons go after me in the operating room to recreate the fullness of the breast. It is VERY important to talk frankly with your plastic and general surgeons about how frequently they encounter this situation. Yes, it happens. But it happens less often and with less severity to better, more skilled General Surgeons. ASK the staff members at the office and your surgeons (especially the plastic surgeon! They may know who has the BEST results .... it may not be who you are with at that time!) what your community percentage of nipple and mastectomy flap necrosis is - they should know. You may have been working with a general surgeon who you may like and may trust, but that that does not mean that are good in the operating room. If you learn that they have a high rate of tissue death with mastectomy surgery, or they aren't comfortable/don't do nipple sparing - maybe you should try another. Don't settle! 

Breast reconstruction, nipple reconstruction, breast cancer, DCIS, mastectomy, TUG flap, DIEP flap, Latissimus flap, fat graft i

The mastectomy itself is a stressful operation for the skin and fat of the chest that remains.  This tissue is stressed again when we place tissue expanders of DIEP flaps in the case of an autologous reconstruction.  This tissue has to heal and in many instances small areas are unable to survive.

Mastectomy skin necrosis

It sounds like you are experiencing some healing issues after your mastectomy.   Your are probably experiencing what's called mastectomy skin necrosis.   This can occur in smokers or if the skin flap from your mastectomy is too thin to survive.   If and when this occurs, early intervention to remove the dead skin helps to save your reconstruction.

Best of luck

Dr. Basu

Houston, TX

Mastectomy and skin issues

Mastectomy flaps sometimes do not heal well because they are too thin and sometimes do not have adequate blood supply. Usually a small debridement ( cleaning of tissue) is all that is necessary to re-close the incisions.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 23 reviews

Mastectomy

Assuming that you had no reconstruction done. The mastectomy may have been a skin sparing or nipple sparing mastectomy. Some times the skin vascularity is compromised and one looses skin which have to be cleaned (debrided), then close the skin either primary closure or with a flap. It happens but not very common.

Samir Shureih, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 6 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.