20 days post op Breast Augmentation/ Lift, I have a huge open wound. Is this normal? (photos)

had a BL with 510 cc silicone BA on 6/9. 1 w the T junction on my left breast started separating, my PS told me just keep it clean and change dressing (Went to board certified PS but 1200 miles from me) 14d my right breast started to open.I have a new RX to prevent infection, went to the ER, its not infected. Called PS, told them the right is open, and they told me to continue cleaning and changing dressings and it will heal. I'm so scared/depressed! If you can give me any advice please do!!!

Doctor Answers 11

Open wounds post augmentation

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Sorry to be late on this but your case is so  unfortunate I still would like to address it. 
Hopefully by now you are better and the wounds are closing. 
There are several important issues here and I will take them in no particular order. 
1. You did not have a breast augmentation. You had an augmentation mastopexy and over 500cc is a lot for that operation and that amount of volume may put the flaps in a compromised situation in terms of blood supply, which it appears has happened to you. In 20 years I have never done simultaneous mastopexy with an implant over 300cc. Unnecessary. 
2. If you are from Tuscaloosa , Alabama you are literally within 45 minutes of some of the best breast surgeons in the world. To put things in perspective for you,  there is an honor society for Plastic Surgery called the American Association of Plastic Surgery. There are only 300 members worldwide and you have to be peer selected by other board certified plastic surgeons based on making a significant contribution to the field of plastic surgery. You have four members of the 300 within 45 minutes from you. Why in the world would you travel 1200 miles?
Here are some of the reasons people do so:
Information on the internet is ADVERTISING and much of it just plain BS. Everyone claims to be a "world renowned" surgeon. 
Reality TV shows do not select based on qualifications but based on the location of the practice and whether or not they think the surgeon makes good TV. Dr. Rey was not even board certified and did not train at Harvard as he claimed but in Memphis.
 Even online reviews can be misleading since now some doctors can pay for them. If you see hundreds of 5 star reviews and no negative ones, you are looking at a marketing genius , not reality.
Even if you traveled that far based on a personal recommendation from a friend, when you have excellence all around you ,the issues with post op care for potential complications is such that it is not worth it when you can get great care from a truly excellent surgeon right here at home. 
If you have not already found a local surgeon to care for you I can recommend some. Dr. Cohn is a partner with Dr. Jim Grotting (one of the Association members) and either one of them would take great care of you. Dr. Mike Beckenstein does virtually 100% breast and is a very nice man, Dr. Mike Clinton is also excellent, very experienced, and very compassionate. 
I would be happy to see you as well but any one of these guys would take great care of you and would be very capable of the revision that will certainly be required. 
As I said before, hopefully you have already found someone and are well on the way to recovery. I am so sorry this has happened to you. It should not have happened.
3. Smoking and Nutritional issues can cause this. I once had a patient whose chiropractor put her on a ton of "supplements" and she didn't tell me since she didn't think vitamins were medications. When her wounds would not heal we eventually found that she had shut down her inflammatory wound healing response due to all the "supplements" so once we got her off them she was able to heal. Smoking will also cause this even when the surgery is done well. 
I wish you all the best. 

Birmingham Plastic Surgeon
4.6 out of 5 stars 13 reviews

Wound complication

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I'm sorry that you are having this complication.

This wound needs the attention of a plastic surgeon, either locally or your original surgeon 1200 miles away.  A large wound like this can sometimes be managed with dressings, but may need surgery to re-close it.  There's also a possibility the implant may need to be temporarily removed, as well.  Only a plastic surgeon can make these determinations in person.  

Don't try to manage this on your own. - get help.

Large open wound after breast lift and augmentation needs immediate plastic surgery care

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Although wound breakdown is common in this area your skin loss areas quite large and needs attention.  If you cannot go to see your plastic surgeon 1200 miles away then you need to consult a local board certified plastic surgeon for wound care.  At this point the tissue looks clean and healthy but you need proper wound care to facilitate healing and follow-up to make sure the implant does not get infected.  Please seek immediate attention from certified plastic surgeon.

20 days post op Breast Augmentation/ Lift, I have a huge open wound. Is this normal?

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I'm sorry to see/hear about the complication you are experiencing. You'll be best off seeking consultation in person with board-certified plastic surgeons with significant experience helping patients with breast lifting surgery. Although the wound may go on to heal, the main concern is that there is an underlying breast implant that may become exposed/infected. Only in person evaluation and careful clinical decision-making will provide you with the best outcome possible. Best wishes.


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I agree that you need prompt care from a qualified PS. The big risk is that infection gets to the implant and that will mean it will have to come out. I hope you have already sought the help of a local PS. Best wishes 

Minor ones after augmentation and mastopexy are not unusual but this one is exceptional.

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This is a very large wound after a mastopexy breast augmentation. I would worry that the breast implant is in jeopardy. This needs to be Closely managed by your plastic surgeon.

20 days post op Breast Augmentation/ Lift, I have a huge open wound. Is this normal?

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Unfortunately you have a wound dehiscence of the inverted T incision. In fact a rather large one. You need to be seen by your PS ASAP!. Cause most likely to large of implant used to attempt a T closure... 

Breast Lift Complication

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Sorry to hear about this problem.  You have loss of skin on both breasts that should be cared for by your surgeon as soon as possible.  This is a problem that does occur but not frequently.  Usually due to excessive tightness and swelling.  It appears to be clean but does need some attention.  I do not think you should accept hearing that it will heal.  Go in and have your doctor examine you and treat appropriately.  You may need more surgery to correct and avoid excessive scarring.

Robert J. Spies, MD
Paradise Valley Plastic Surgeon
5.0 out of 5 stars 95 reviews

Wound healing problems after a breast lift and augmentation

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Unfortunately you have a severe wound healing problem and you are 1,200 miles away from your plastic surgeon.  This type of wound requires meticulous wound care and frequent rechecks by your surgeon to heal successfully with out further complications.  If your implant becomes infected you will have a full blown disaster.
The ER physician will not know how to care for this wound.  This requires the care of a plastic surgeon and it can not be done long distance.  It is likely that there was some degree of vascular compromise of your skin flaps which allowed the wounds to completely separate.  Try to find a plastic surgeon in your area who is willing to take over your care or get to your original surgeon as soon as possible.  Once the wound is completely healed the scars can be revised and you should look okay.    

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Re: Breast Augmentation/ Lift, I have a huge open wound. Is this normal?

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Hello, thanks for your question and images.

You seem to have dehisced, or separated at your incisions on both breasts by the views you provided on your images.

I agree that you will heal over time. It is good news to know that your wound care regimen has kept the area infection free, and allowed the area to begin healing. 

I hope this helps,

Thank you,

S.P. Maggi, MD, FACS
Austin Plastic Surgery Center


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