Tissue Necrosis After Breast Reconstruction. I Would Rather Be Flat Than Look Like This? (photo)

I had skin sparing bilat mast, breast recon with TEs. 1 week later had reaction to surgical tape. PS said remove tape. I did so and discovered tissue necrosis along vertical incisions on both breasts and large black area at bottom of right breast. PS cut away the necrotic tissue at bottom of right breast leaving a large, gaping hole. Was told to apply wet dry dressing. I'm worried about scarring and would like to know how this is going to be fixed. TEs appear to have been overfilled to me.

Doctor Answers 4

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

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First of all your overall snap looks good.  When any Board Certified Plastic Surgeon discusses the procedure we discuss wound healing issues.  This area of specific breakdown is at the point with the most limited blood supple at we traditionally call triple point.  We all have had areas of breakdown in wounds breast reconstruction and breast reductions in these areas.  These operations put a great deal of stress on the tissues.  The tissue that was not going to live was removed.  Dressing changes with help get this healed.  Of course the scars can and normally revised during an implant exchange.  Be patient and work with your surgeon.  I would also recommend carefully analyzing you diet and any other health conditions that can delay wound healing.

Tissue loss after Breast Reconstruction?

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Unfortunately, these things happen with any type of surgery, and are more common after a breast recon using skin sparing techniques. I would encourage you to follow your surgeons plans, and ask him about a possible wound vac. You will be grateful and happy once your recon is done, but it does take a few steps and some time. Your final breast size and appearance will look drastically different after your final surgery.

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

Breast Reconstruction

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Skin Sparing Mastectomy carry some risk of skin loss because of vascular compromise.

The area of skin loss you have seems superficial, skin only, and will heal on its own within 3-6 weeks. There will be a scar, but when the tissue expander is to be removed that scar can be revised, and will be hardly noticable.

Samir Shureih, MD
Baltimore Plastic Surgeon

Tissue necrosis after reconstruction

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You underwent a Wise pattern mastectomy which can carry some higher risk of skin flap necrosis. The expander is not exposed which is good.  You may be able to undergo a closure of both these wounds in the office under local after it looks like all necrotic tissue is demarcated and have excellent results eventually.

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.