Wound dehiscence and infection after breast reduction

Wound dehiscence and infection after breast reduction

07th Mar 2018

Overly large breasts can be a source of physical pain and emotional discomfort for many women. Women with very large breasts experience physical pain, in addition to self-esteem issues. As such, many of them opt to go under the knife. Breast reduction surgery is a plastic surgery procedure that reduces the size of overly large breasts by surgically removing the excess skin, tissue, and fat from the breasts.

Breast reduction is a very invasive procedure. It involves side effects, risks, and complications like other invasive interventions. Two problems that may happen after the surgery are wound dehiscence and infection. There are many factors that expose patients to these problems. Wound dehiscence happens when the incision opens up, creating bleeding and other problems.

Wound dehiscence and infection after breast reduction

Wound dehiscence is a problem that may happen after breast reduction. It occurs when the incision opens up. Breast reduction surgery involves incisions on the breasts. The incisions are made to remove the excess tissue, fat, and skin from the breasts. After the procedure, the incisions are sutured and closed.

Your recovery starts right after the procedure. During the recovery, there is a risk wound dehiscence may occur. It can occur when the edge of the wound splits open before the incision has healed. Wound dehiscence is often accompanied by infection and bleeding. When the wound opens up, it exposes you to possible infections. Your risk of infection is greater if you have a weak immune system.

Wound dehiscence and infection after breast reduction are major problems, and the patient must get the conditions treated as soon as possible. The patient can reduce these risks by being careful during the recovery period and following the surgeon’s instructions.

Types of wound dehiscence and infections

Wound dehiscence can occur in two different forms. First, partial wound dehiscence occurs when the superficial layer of the skin or tissue opens up. On the other hand, complete wound dehiscence happens when all the layers that have been sutured and closed after the surgery split open, exposing the underlying tissues like the breast muscles.

Infection after breast reduction surgery can also happen in three different forms. First, a superficial or mild infection happens when the infection is minor and limited to the exterior or initial layers of the breasts. It can be treated with oral antibiotics. The second type of infection is moderate. It affects more tissues in the breasts. Oral antibiotics can treat it as well. On the other hand, a severe infection is deep and happens when the infection affects the underlying tissues like the glandular tissue, breast muscles, skin, and the incision. It must be treated immediately through IV antibiotics.

Symptoms of wound dehiscence and infection

Depending on how severe the wound dehiscence and infection is, the complications may present certain symptoms. First off, these problems can trigger bleeding at the incision areas. The incision will split open and the sutures will be broken. The patient may experience pain in the breasts. You may also see pus and fluid discharge from the incisions. In case of severe infection and wound dehiscence, the patient may experience a rise in temperature, vomiting, nausea, and sickness. Swelling that expands beyond the surgical site can also be a symptom of wound dehiscence and infection.

Causes of wound dehiscence and infection after breast reduction

There are many factors that can cause wound dehiscence and infection after breast reduction surgery. The primary factors held responsible for these complications include carelessness by the patient during the recovery period, diabetes, the use of blood thinning medications, poor skin quality, and obesity.

There is a risk wound dehiscence and infection may happen in case the doctor removes the sutures prior to the complete healing of the incisions. Furthermore, an infection can give rise to wound dehiscence as well. To prevent these problems, you must choose your plastic surgeon carefully and follow his instructions for a smooth and safe recovery.

Some studies have even linked health issues like heart disease, high blood pressure, and poor wound healing with wound dehiscence and infection. Your lifestyle and smoking can also cause these problems. If the wound has not been properly sutured and closed, you are at higher risk of wound dehiscence and infection. If your surgeon is inexperienced, he may end up only suturing the superficial tissues instead of the underlying tissue layers.

Another cause of wound dehiscence and infection is the removal of excess skin from the breasts. If the surgeon ends up excising more skin from the breasts, it can create tension and strain on the incisions, hence leading to incision separation that can be followed by infection. To prevent this condition, the plastic surgeon must excise the skin with care and use a conservative approach to skin removal from the breasts.

Even though most of the sutures used on the breasts are profound and absorbable, some of the sutures from the superficial layers of the skin still need to be taken out after some weeks after the surgery. The sutures should ideally be taken out when the breasts have completely healed. In case they are removed before the breasts have healed, it can result in incision splitting, bleeding, and infection.

There is also a possibility that an infection will happen first, which will then trigger wound dehiscence. Infection can cause the edges of the incisions to split open, triggering bleeding. To prevent this condition, you must follow the surgeon’s instructions and be extremely careful during the recovery period.

If you have diabetes or anemia, your risk of infection and wound dehiscence is greater. Moreover, pressure or strain applied on the incisions can result in wound dehiscence. For example, when you sleep on your front during the first two weeks of the surgery, it can apply pressure on the incisions, resulting in wound dehiscence. Pressure applied to the breasts as a result of sneezing, coughing, and stretching can also result in wound dehiscence that may be followed by infection.

Smoking is yet another major cause of wound dehiscence. Smoking causes the wounds to heal slowly and poorly. It reduces blood and oxygen flow to the wounds, increasing your risk of wound opening. Moreover, if you are older, you are at higher risk of these problems.

Preventing wound dehiscence and infection after breast reduction

Wound dehiscence and infection after breast reduction can be prevented. The first step to prevent these problems is to choose your plastic surgeon carefully and follow his instructions to the letter. If the surgeon has told you to wear the surgical bras after the procedure, be sure to wear them for the recommended time. Also, take all the prescribed medications on time and according to instructions of the doctor.

Secondly, you must share your complete health and medication history with the doctor in advance of the surgery. Doing so can go a long way toward preventing the conditions. If you are a smoker, you must stop smoking at least two weeks before the surgery and avoid smoking during the recovery period. Furthermore, you must avoid physical movements and activities during the first two weeks of the surgery and avoid physically demanding activities for six weeks after the operation.

Staying healthy and avoiding a poor lifestyle after the surgery can help prevent wound dehiscence and infection. Be sure to stick to a balanced and healthy diet. Avoid any activity or movement that can apply strain on the wound during the recovery period.

Treatment of wound dehiscence and infection after breast reduction

The treatment for wound dehiscence and infection after breast reduction starts with the use of antibiotics. If the infection is mild or moderate, oral antibiotics are sufficient; however, in case of deep infection, IV antibiotics will be used. The surgeon will then disinfect and clean the breasts. The infected tissues will be removed and the doctor will then properly suture and close the wounds. After the treatment, the doctor will monitor your health and progress for many weeks after the surgery. Your surgical dressing must be changed from time to time to avoid wound dehiscence and infection from recurring.


Breast reduction is a plastic surgery intervention that is used to treat overly developed breasts. The surgery involves removal of the excess tissue, fat, and skin from the breasts. The procedure is not free of side effects, risks, and complications. Wound dehiscence and infection are two complications that may happen after the procedure. The common reasons why these complications occur and the treatment options and tips for prevention have been discussed in detail above. Patients considering breast reduction must discuss wound dehiscence and infection with the doctor during the pre-operative consultation.

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