Should the white tissue be removed? (Photo)

Question

My surgeon in Miami (the person who actually did my BL/BA) recommends that the white tissue be removed/scrapped off.  However the surgeon I’m following up with in nyc recommends taking a more gentle approach. I seen him in the office today and he says to avoid infection, loss of tissue and or loss of implant I should continue thoroughly cleaning my wound and changing the dressing. At this point im confused and what like to know what may be the best or better approach.

S. Larry Schlesinger, MD, FACS · Answer

The short answer is NO.As you can see from the little red island sitting on white tissue, this is a good recipient bed on which granulation tissue (the red tissue) can grow.  Once this white area is completely covered with granulation tissue (fibroblasts and capillary buds), then myofibroblasts can start to contract the wound making it smaller and smaller until it completely heals.  Removing the white area takes strength away from this area and allows it to spread wider.  It also takes away the bed on which granulation tissue can grow. All the above wound healing mumbo jumbo means that your plastic surgeon in New York City is correct.

Yannis Alexandrides, MD, FACS · Answer

I don't know how many days or weeks it's been since the operation but I assume that because there are stitches there that it's still early days. My first impression is that this will need a little more time before the skin is removed. The surgeon needs to do an examination to decide what to do. My first impression is that if it's early after the surgery, not to do a debridement yet.

Daniel Barrett, MD · Answer

Dear latyahc,this type of wound is not uncommon after breast lift. It is usually caused by poor blood flow. I would suggest you to consult your plastic surgeon, follow your surgeon's instructions and keep your wound clean and covered. It can take few weeks or months for wound to fully heal. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Michael Loffredo, MD · Answer

it is diffuse to make a clear decision from one photograph, but I do agree with the plan to continue local wound care rather than debridement

Robert H. Hunsaker, MD · Answer

I generally tend to go with a less aggressive approach and treat these with dressing changes and often use silver sulfadiazine cream as well - at least until it pinks up more, then I switch to a plain topical antibiotic. Not there is anything necessarily "wrong" with skilled debridement but I would go with the advice of your treating surgeon.

Should the white tissue be removed? (Photo)

Answers (5)

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