American Society of Plastic Surgeons
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kawood
one month ago
Answered

What went wrong

I am 7 weeks post op from breast lift and I have been dealing with a major complication. The 1st picture is from 26 days ago and the 2nd picture is from the other day. The wound has double in size and no one can tell me why. I am seeing a wound specialist but he says just change the dressings every other day. This wound has gotten bigger and it hurts.. I don't know what to do

Procedure: Breast Lift
Location: wilburton, OK

Replies 8

Thomas Sterry
ASPS Surgeon
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Oh, I am very sorry to see this. The photo is a little close for perspective, but I think you are showing the wound below the nipple has opened. In the long run, these situations can end up with very good results. Yes, really.

Right now the best move is probably to treat the wound with local care (dressing changes) a couple of times a day - which is what it looks like you are doing. Some of the yellow tissue will eventually come off and the wound will become even more "beefy red". Next, it will begin to contract and the surrounding skin will heal over the top.

If the scar does not contract enough to make a cosmetically acceptable result, then a few months after healing you can have a scar revision.

Again, sorry you are going through this, but you may very well end up with a terrific outcome. Hang in there!

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Arturo Munoz Meza
ASPS Int. Surgeon
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That is a mycobacterial desease, you need to be attended ASAP, maybe VAC SYSTEM may be helpful

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Norman Bakshandeh
ASPS Surgeon

Patience is the key here. If there is a implant its not exposed. That is great news. This will heal with wound care including dressing changes and showers. You may need a scar revision. hang in there

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Rahul Vemula
ASPS Surgeon
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So sorry you have had this experience. Although we do not have your before picture as well as immediate post op pictures, one can infer from this that you most likely had some full thickness skin loss after your lift. This can happen for many reasons and without complete information, its impossible to give you an exact answer on what why this happened. You need to have close follow up with your plastic surgeon until this is healed. You may need a revision surgery in the future once all the inflammation has subsided. Best wishes. Things you can do to help wound healing are increase your protein intake, and stay away from any nicotine products even second hand smoke, and if you are a diabetic make sure your diabetes is controlled.

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Andre Mattos
ASPS Int. Surgeon

This seems like pyoderma gangrenosum. The treatment is clinical with corticosteroids. This diagnosis needs to be ruled out before any treatment. Consult an experienced surgeon in your area

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Robert Oliver
ASPS Surgeon

You had a full thickness loss of skin over that area. The distribution and residual skin slough suggests this was a vascular issue of the skin flaps they made rather then an infectious one. Given the large size, that is NOT a wound you would simply let heal in by secondary intention (scarring) as it would take several months and result in significant scar contracture. Traditionally this large an area of skin loss would be considered for a skin graft to close

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Ahmed Attiyah
ASPS Int. Surgeon

Wound separation can be treated successfully with early and proper wound care then revisionary procedure

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Elliot Jacobs
ASPS Surgeon

This is a major complication with a large area of full thickness skin loss. There is also some surrounding areas of redness, which may represent infection. This will not heal by itself -- even over many months. Your first job is to get the wound cleaner, which can be done with topical care -- and then the wound should be closed with a skin graft. Once the skin graft is healed, you will have time to assess what will be needed for the next stage of reconstructing your breast. It is possible that removal of the implant may be needed to assist in the healing and reconstructive process. Good luck!

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