4 Weeks Post Op and a Large Hole Forming in Right Breast at Crease, Is It Normal? (photo)

I am 4 weeks post op; at 3 weeks right side stitiches split at crease; 5 days later it worsen. Went to PS and she clipped verticle stitch, said no infection and gave me silver cel to place over quarter size hole and gauze. She said use desenex in area to keep dry. She said this is normal and not worry. How can you not worry with quarter size hole!! Is there anything else I can do? Any idea how long it takes to heal? Any herbs helpful? I am desperate and going crazy, which is no help.

Doctor Answers 4

Incision healing problem

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A quarter size hole in your incision four weeks after surgery is not the norm. If you are continuing to hae drainage and you have an implant in place, you will likely need to have the implant removed at this point for at least three months to get this to heal and then go back and replace the implant. If there is an implant is it visible in the hole. If so, it will likely need to come out. You should see your board certified plastic surgeon to address your concerns. If this is a superficial wound that is granulating (looks like a raw piece of steak), then it will likely heal with conservative wound care measures, but may take 3-6 weeks. Again your surgeon should be able to help you with this.

Tucson Plastic Surgeon

Quarter-size "hole" in incision 1 month post-op is NOT normal!

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I suspect your surgeon did not actually say that this was "normal." What she is implying is that nothing other than continued conservative wound care is needed at this time. This wound looks clean and non-infected.  You state that you had a "lollipop" breast lift, but did not state if implants were used. If so, this open wound could be a portal for bacteria to contaminate your implant and cause infection for which removal is required--a much more serious potential concern.

However, if you underwent a breast lift without implants, this open wound is certainly NOT normal, but incisional breakdown and areas of incomplete healing are not uncommon with this kind of lift. Areas such as the natural inframammary crease are more likely to become macerated and open up, as these areas are moist, irritated, and subject to more stress than other parts of your incision. Another drawback of vertical breast lifts is your scar crossing your natural inframammary crease onto your chest wall--just one of the reasons I am not a big fan of this type of lift.

You do NOT need herbs. You need continued follow-up with your surgeon, or with another ABPS-certified plastic surgeon if you have lost faith in your own doctor. Wounds such as this have happened to ALL of us answering questions here. How your surgeon cares for the problem is the mark of proper care. The advice she is giving seems adequate, and unless things worsen, I would recommend following her advice.

This should heal up over the next few weeks, and the scar will be remarkably smaller than the present wound size (scars contract). Keep it clean, keep it dry between dressing changes, and see your surgeon ASAP if anything worsens. Signs of concern would be increasing size of the open wound, purulent drainage (pus), increased redness around the wound, swelling in the rest of your breast, increased pain, fever or chills, or just feeling rotten. If any of these occur, call your doctor for an appointment right away. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Incision issue after breast lift?

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Did you have a breast lift and implant placed?  It is unclear form your description. Often if there is no implant, this will go on to heal on its own if it is clean.  If an implant is in p lace, you risk an infection, and it may need to be removed.  An exam is key. Follow closely with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Hole at the incision site 4 weeks after an augmentation mammoplasty

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You photo was difficult to assess, but I assume the hole is at the incision site. If tis is so, it is definitely not normal. If it was, you would have one on the other side too. When wounds are closed, they should be closed for good with no holes or drainage. If their is drainage from the hole, this is not a good sign. Either a suture came loose or you have an infection. If you have an infection, a topical antibiotic is inadequate treatment. You need a second opinion from a board certified plastic surgeon at once. If the implant becomes exposed, it will probably have to be remove and replaced at a later date. Do not delay seeking another opinion, and good luck.

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.