Breast reduction surgery is a highly effective operation at downsizing and reshaping large breasts. It is a fairly complex procedure that uses a keyhole skin removal and reduction approach to lift the nipple upward and create a more conical shape to the breast. From a plastic surgery standpoint, this is known as the ‘inferior pedicle’ technique and is the most method by which plastic surgeons perform breast reductions in the United States. There are other techniques for performing breast reduction, but the inferior pedicle method is reliable and adaptable to all types of breast sizes and shapes.
One of the most common complications from this method of breast reduction is separation or opening of the anchor or inverted T portion of the closure at the lower breast crease. This occurs so often that I inform all patients to expect it in either one or both of their breasts. This opening after surgery occurs because this is the point of maximum tightness or tension of the skin closure and, as healing and inflammation set in, the wound edges will separate. Sometimes it will be small, a dime or nickel size, and in others it can develop into an opening much bigger.
What is peculiar about this problem, and very disturbing to patients, is that it does not usually appear until at least three weeks after surgery. The incision lines from the breast reduction look great for weeks and then this develops. By three weeks most patients assume that all potential ‘problems’ are over and everything will just continue to get better. But the biology of healing goes against this perception as the onset of inflammation and wound tension relief create this delayed wound problem.
Despite its ominous appearance, this breast wound separation is a self-solving problem. It may take a week or so reach its maximal size but it will heal and fill in on its own over the ensuing weeks.
Dr. Barry Eppley
Indianapolis, Indiana