4 weeks post op, I have a dehiscence wound on my lower part of breast. What treatment would you recommend? (photo)

Breast augmentation will always leave a scar, even if you don't experience complications. However, scarring can be controlled with things like silicone sheeting and silicone gels, which can be used after the incision closes and the steristrips fall off. There should be no crusting or scabbing either. Keep your scars out of the sun for about a year after surgery to prevent permanently darkening them as well. Best of luck.

It sounds like you have a good surgeon and you're working together to help the area heal.  Of course you already have a scar line from the surgery itself.  The wound healing period is critical to ensuring infections don't take hold.  Worry about healing the wound now, and worry about the scar later.

Thank you for the picture. This is typical breast reduction/lift with an anchor incision. Just local wound care will allow it to heal. This scar will be minimal and unnoticeable unless you directly advertise it by lifting your breast and displaying it. Continue to follow up with your plastic surgeon

Small areas of wound breakdown can happen and are not often a problem. I am concerned that you state that your surgeon "drains" it. Do you mean that he removes dead tissue or that he removes liquid like pus? Also, is there a breast implant in there? If there is an implant than there may be an infection and your implant may need to be removed. Speak to your surgeon and if you are not comfortable with him/ her, seek another opinion (in-person) immediately.

My concern would be whether the implant is exposed. If it is, then it ismandatory to remove the implant as the infection will only worsen. If you have a superficial cellulitis, then I would stop the antibiotics and get a wound culture. Restart the antibiotics after you get the results of the wound culture. An MRI would most likely give you an idea if the implant is involved.

YES! Follow the instructions of your operative surgeon as to wound care and be seen at least weekly... 

These little areas of wound healing trouble at the junction of the breast lift scars is not that uncommon. Typical treatment is indeed keeping it clean, topical antibiotic cream and time. Most often they will heal in 4-6 weeks. Of course there will be a scar as there would be one even without the trouble. It may be unsightly enough that you may choose to do a minor revision at an appropriate time down the road, but most patients in my experience are satisfied enough that they never revise it.

The photo itself, showing a small area of separation and the intersection of the vertical and horizontal incisions is not particularly troublesome.  What I don't quite get is what you mean by the surgeon draining the area.  If there is fluid around the implant, and an adjacent open wound, that would be of concern, and the concern is for implant infection. As to scar, every incision results in a scar. Usually with a small area of breakdown as seems to be the case here, the healing proves to be normal. If not, a minor touch up is almost always successful. Follow closely with your surgeon. All the best. 

The most important thing is that you are seen regularly by your surgeon. The scarring can be revised but the most important thing is that no infection is present around your implant, although you do not mention specifically that you have an implant. Regular dressings and supervision from your surgeon are the importnat thingsRegards

Small wound break downs at the "T" does occur in some patients. Often they go onn to heal with local wound care.  Persistent drainage could represent a seroma or fat necrosis.  Keep a close eye on it with your surgeon.