American Society of Plastic Surgeons
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chinita
5 months ago
Answered

Should I go to a wound center ??

I had my breast reduction 17 days ago . My surgeon told me I problably had a hematoma since I experience alot of bleeding for the last 3 days : it finally stopped but now I have this new opening. Should I get this close up? My surgeon it’s 2 hrs away!

Procedure: Breast Reduction
Location: perth amboy, NJ

Replies 6

Richard Bosshardt
ASPS Surgeon

Unless your breast becomes infected- with redness, increasing pain, swelling, heat, firmness of the tissues- this hole will probably heal satisfactorily with time and local wound care. I would wash the area with soap and water twice a day and dress it with something like Bacitracin ointment. Keep a telfa pad or gauze over it to protect your clothes from seepage. Use a sports bra to secure the dressing so you are not constantly taping your skin as this can cause irritation. Be patient. The scar may just turn out OK as well. Time is your friend. If any of the signs of infection I listed above develop, call your surgeon about starting antibiotics. I would not start them just because it is open. Every breast surgeon gets these complications now and again.

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Chinwe Kpaduwa
ASPS Surgeon

I agree that this does not appear infected and will heal with local wound care. If you do not want to see your surgeon because he is relatively far away, I would call his office to be referred to a wound care center to be evaluated and started on adequate treatment. It looks like there is some depth to the wound that may require packing.

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Rahul Vemula
ASPS Surgeon
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It’s best to have a post operative visit with the surgeon since you are so early post op.

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Alfred Antonetti
ASPS Surgeon

This is a problem that happens sometimes with a breast reduction. It is not an infection but could turn into one and then it needs to be treated. The wound will finally close with frequent soap and water and dressings but it may take quite some time. My guess is that the wound will spread and get bigger and bigger before it starts to close. In my opinion, and this is only my personal opinion, wound care centers are a waste of time and money. The best qualified person to take care of your wound problem is your own plastic surgeon. You need to be in close contact with your plastic surgeon. Sometimes you can solve a lot of things by phone. One thing to consider is the use of a negative pressure dressing such as a "PICO". This needs to be changed weekly but I think with its use, the wound will heal in about 2 weeks as opposed to2 months. It may cost up to $300-$400-per week but your insurance company may pay for it. Mention the use of a negative pressure dressing to your PS or wound doc.

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Enrique Almonte Checo
ASPS Int. Surgeon

Hello there! That is correct! You probably had an haematoma underneath your sling and as a result actually looks like a wound dehiscence and should be attended promptly to avoid progression of dehiscence and or contamination and consequently infection of the wound. A culture of the area is advised. Yes, you must attend a wound center or visit your doctor as soon as possible.

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Raffy Karamanoukian
ASPS Surgeon

Wound breakdown is disconcerting but can occur. Proper communication and follow up visits with your surgeon are ideal, regardless of how far he is from you. I would clean the wound at least twice daily and consider a negative pressure system, optimization of your diet, and comprehensive wound care.

Best,

Dr. Karamanoukian

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