Is this post mastectomy skin necrosis? (photos)

This photo was taken on 5th post op day. Is this serious? Is this viable? If not what will happen next? Please tell me the best treatment options? Unfortunately no plastic surgeon is available here.

Doctor Answers 6

Post mastectomy haematoma

Hi


I looks like small blood collection ( haematoma) after surgery. Most would heal without  any intervention. Some of them do required ultrasound guided or open drainage 



Mr Haresh DEVALIA

Consultant Breast and Oncoplastic Surgeon 

Post mastectomy haematoma

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi


I looks like small blood collection ( haematoma) after surgery. Most would heal without  any intervention. Some of them do required ultrasound guided or open drainage 



Mr Haresh DEVALIA

Consultant Breast and Oncoplastic Surgeon 

Mastectomy flap necrosis

This area will need to be removed and allowed to heal.  At that point reconstruction can be evaluated. 

Three basic forms of breast reconstruction exist. You can use your own tissue, implants or a combination of the previous two techniques. Your own tissue can be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one stage (DTI) or two stage. One stage reconstructions are best for patients without a great deal of sagging and moderate breast size.  This allows for the placement of an implant to fill out the pocket left by the mastectomy without excess skin. Two stage reconstructions are started by placing expanders at the time of mastectomy. Tissue expanders can be placed above or below the muscle.  If placed above the muscle they are completely wrapped in alloderm. Expanders are inflated initially in the operating room and in the office as an outpatient.  Exchange to permanent implants can be performed after the desire volume has been reach and adequate wound healing has occurred.

Mastectomy flap necrosis

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This area will need to be removed and allowed to heal.  At that point reconstruction can be evaluated. 

Three basic forms of breast reconstruction exist. You can use your own tissue, implants or a combination of the previous two techniques. Your own tissue can be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one stage (DTI) or two stage. One stage reconstructions are best for patients without a great deal of sagging and moderate breast size.  This allows for the placement of an implant to fill out the pocket left by the mastectomy without excess skin. Two stage reconstructions are started by placing expanders at the time of mastectomy. Tissue expanders can be placed above or below the muscle.  If placed above the muscle they are completely wrapped in alloderm. Expanders are inflated initially in the operating room and in the office as an outpatient.  Exchange to permanent implants can be performed after the desire volume has been reach and adequate wound healing has occurred.

Post mastectomy flap necrosis

This does look like necrosis to me. I hope you have access to care in your area, or can travel to see a qualified plastic surgeon after you have had some time to heal.

Post mastectomy flap necrosis

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This does look like necrosis to me. I hope you have access to care in your area, or can travel to see a qualified plastic surgeon after you have had some time to heal.

Breast Reconstruction/ Breast Implants/ Anatomic Gummy Bear Implants/Silicone Implants/Revision Breast Surgery

I appreciate your question.

Since there has been a change in your post op course, please contact your surgeon so he/she can examine you and recommend the most appropriate treatment plan at this time.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
#RealSelf100Surgeon


Breast Reconstruction/ Breast Implants/ Anatomic Gummy Bear Implants/Silicone Implants/Revision Breast Surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I appreciate your question.

Since there has been a change in your post op course, please contact your surgeon so he/she can examine you and recommend the most appropriate treatment plan at this time.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
#RealSelf100Surgeon


Reconstruction

cant be 100% sure but sure looks like it is drifting that way. surgeon probably going to wait a little while longer to let things declare and thenact. stay in close touch with him

Jonathan Saunders, MD
Newark Plastic Surgeon
4.7 out of 5 stars 65 reviews

Reconstruction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
cant be 100% sure but sure looks like it is drifting that way. surgeon probably going to wait a little while longer to let things declare and thenact. stay in close touch with him

Jonathan Saunders, MD
Newark Plastic Surgeon

Post Mastectomy Skin Flap Necrosis

Thanks for reaching out.  Yes that looks like skin flap necrosis.  You need to see your surgeon immediately.  What happens next depends on a couple of things.  Do you have a tissue expander in place?  Is there anything under that skin.  It is hard to determine from a photo alone whether or not that is full thickness or partial thickness.  You may eventually need that skin to be removed.  It is best to see your surgeon right away to come up with a plan.

I hope this helps :)

Post Mastectomy Skin Flap Necrosis

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thanks for reaching out.  Yes that looks like skin flap necrosis.  You need to see your surgeon immediately.  What happens next depends on a couple of things.  Do you have a tissue expander in place?  Is there anything under that skin.  It is hard to determine from a photo alone whether or not that is full thickness or partial thickness.  You may eventually need that skin to be removed.  It is best to see your surgeon right away to come up with a plan.

I hope this helps :)

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.