Pus filled sac on incision site 5 weeks after surgery - help please! (Photo)

When you hear the sound of hoof beats, think of horses and not zebras.Infection after a breast surgery is certainly a possibility, but it usually occurs before 5 weeks.  The most common cause of a bump with some redness and potentially leaking of what appears to be pus is what is known as a STITCH ABSCESS.  Most plastic surgeons will close the outside of the skin with permanent sutures that have to be removed.  Stitches under the skin, known as subcuticular sutures, are most often dissolvable sutures.  The process of dissolving most of these sutures includes a lot of white blood cells coming to the area and eating up the suture material.  At times, there is not enough moisture in the surrounding tissue to allow a complete dissolving of these sutures, and that leads to a sac of partially dissolved suture plus white blood cells which looks like infected pus but lacks the most important element, bacteria.  These stitch abscesses are very easily treated by a Board Certified plastic surgeon.  Your on call plastic surgeon did the right thing by putting you on antibiotics until you could be seen by your own plastic surgeon.  You might have a zebra there, but I doubt it.

It is probably a stitch abscess, but you will need to be evaluated in person. So make an appointment to see your surgeon as soon as possible. Best, Dr. Nazarian

I agree with starting antibiotics as you said.  But I also feel that you need to see your PS as soon as possible to make sure that the infection is only superficial and that the implant does not get contaminated!

I recommend starting antibiotics immediately for this wound infection and being seen by your surgeon today if possible.  Good luck!

It is rare to have an infection after breast augmentation particularly this far out from your surgery.  A course of antibiotics is a reasonable first step.  It is possible that this represents a superficial infection near the suture line that could resolve with conservative (non-operative) measures.  Nonetheless, an in-person examination would be required to make that distinction and determine the most appropriate treatment plan. 

You should see your plastic surgeon as soon as can be arranged. Though infections at 6 weeks are unusual,they occasionally will occur. These infections should be resolved as quickly as possible to avoid finding their way to the implant. Starting the antibiotics seems reasonable as a first step.

I appreciate your question.

Since there has been a change in your post op course, please follow up with your surgeon as soon as possible for evaluation and treatment.



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

Thnak you for posting your photographs with your question.  I am sorry to hear that you are having this drainage from your incision following breast augmentation. In general, drainage from an incision, increasing pain, redness, swelling and fever are signs of infection. I recommend that you see your Board Certified Plastic Surgeon immediately. You should be examined, the area cultured, drained and started on antibiotics.  Hopefully, this is a superficial infection that will respond to local wound care and antibiotics and does not communicate with the implant pocket. Best wishes, Dr. Richard Swift

Culture-specific antibiotics are a must.  If you experience fever/chills or the redness increases or even persists, you should phone your doctor.  Implant infections are difficult to treat and can necessitate implant removal; it is best to treat this aggessively.

Hopefully this is something simple, such as a "stitch abscess" which usually resolves on antibiotics and removal of the suture. However an exam is essential to evaluate the other possibility which is an implant infection, a more serious problem. See your surgeon ASAP.All the best.