Scar still ozzing 4 months after direct to implant surgery

Options
Theda
Theda Member Posts: 42
edited October 2014 in Breast Reconstruction

Hello ladies,

I wanted to ask if anybody else has had this kind of problem and if they found a solution.

I had my BMX and direct to implant surgery with Alloderm May 29th. Two weeks later, I had an infection that was controlled with 10 days of heavy duty IV in the hospital. Implant and mesh were fine, not infected. Three weeks after that, the scar opened a bit and started oozing. The liquid is not infected, just serum. It has been like that for 7 weeks now ... We tried closing it again twice, but to no avail. I am rejecting the internal stitches, they pop out every few days. After 7 weeks, I am exhausted and done being housebound and not able to do anything. The decision is now to remove the implant on Saturday if it is not closed by then. But it pains my PS to have a perfectly fine implant removed. There is no inflammation, no infection, the breast looks great besides this very tiny hole that keeps leaking.

Any advice would be welcome!

Thanks,

Theda

Comments

  • jbdayton
    jbdayton Member Posts: 700
    edited September 2014

    My entire lower incision opened up so I was able to get a wound vac to help the healing process.  I had a small area on my abdominal scar after an earlier surgery and they had us swab it out with a saline soaked q-tip and cover with a bandage.  

    Hope something can be done to save your implant.  

  • Theda
    Theda Member Posts: 42
    edited September 2014

    Thanks Jeannine! I will try the saline soaked q-tip, I still have 4 days to try something. :)

  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2014

    You might want to inquire about doing a hyperbaric chamber too, to aid in healing. It is possible that your body will not heal with a foreign object stressing your skin. This happened to me with both the first expander and necrotic skin, and again recently after a allograft repair surgery. One possible option if your incisions are on the front of the breast is to remove the implant for a period of time and allow the skin to heal, then put the implant back with a IMF incision which is fed by the blood supply of the skin on the torso.

  • Theda
    Theda Member Posts: 42
    edited September 2014

    Thanks SpecialK! 

    This sounds very interesting, removing the implant for a while. The incision is around the lower half of the areola , so it would be possible. I also think that my body will not heal by itself by now. I will inquire about the IMF incision and hope that my PS will consider it. Way better than starting over again with expanders in a few months.

  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2014

    theda - it is certainly worth a discussion.  I would also ask about the hyperbaric - you might be able to do it after the implant is removed to get the skin to heal more quickly, so as to possibly  avoid having to expand prior to the reinsertion of the implant.

  • Theda
    Theda Member Posts: 42
    edited September 2014

    Sadly, the hyperbaric is not an option in the country where I live. The frustrating part is that the skin looks good, it is only this vey small hole that just won't close or stop oozing, the rest of the scar is fine. I think that removing the implant for a while will definitly help. But I should be able to keep the Alloderm sling, or?

  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2014

    My alloderm was removed along with the implant, and there may be a question of whether or not you will be able to go back to an implant without an expander first.  Another option that was tried as an interim measure for me was a swap to a smaller implant for less stress on the skin.  I was pretty surprised how little size difference there was with an implant 100cc smaller - maybe that is another option for you?

  • Theda
    Theda Member Posts: 42
    edited September 2014

    Ouch, ok, makes sense to remove everything I guess, to give the body a chance to heal. Going smaller sounds good, I have 315g right now and it was the biggest they managed since I was a very small A before. 

    But since the problem seems to be that my body is trying to reject things, the sutures or the implant or the mesh, maybe even a smaller implant will cause the same problems.

    I am coming to terms with spending a few months with a flat side. And as a friend said, it is not like I have a double D on the other side, it won't make much difference. ;)

    Did you have problems only on one side or both?

    Thanks so much for your input, will discuss all this with my PS.

  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2014

    I have only ever had problems with the non-cancer side and only in that one particular area, which stems back to the necrosis.  My PS and I were both quite surprised when I developed healing issues with the March surgery since it had been so long since the original problem.  Unfortunately, I do have quite a problem trying to match a completely flat side with a 650cc implant, it is a daily challenge, lol!

  • Theda
    Theda Member Posts: 42
    edited September 2014

    I also have problems with the non cancer side, my PS told me from their experience, it is always the case, if one side is going to make trouble, it will be the non cancer one.

    Omg, indeed, 650cc and flat, that is a challenge! How much longer do you have to wait?

  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2014

    Originally I had thought that the PS would put in a new expander in Oct (90 days was up in Sept but I have been out of town much of the month) but now he wants to do some preliminary fat grafting to help with the skin. We will start on that in Oct but it remains to be seen how many he does and when. I'm betting a year will elapse from the removal to the next exchange.

  • Theda
    Theda Member Posts: 42
    edited September 2014

    I wish you all the best and that it will all work out with an amazing results. Thanks again for your help! :)

  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2014

    Theda - you are welcome, and I hope the same for you. I am hopeful for a replacement that I can live with, as I have learned to manage my expectations after twelve surgeries.

  • SusieR12
    SusieR12 Member Posts: 22
    edited October 2014

    Is anyone having problems with an incision opening a few weeks after reconstruction SX??? I had a breast lift on the non cancerous breast at the same time of implant exchange...Now the incision has opened about 2 inches wide and PS says it must heal from inside out...It seems to be filling in with new tissue but I have this yellow protein that keeps covering the wound and I don't know if thats good or bad...Any help is appreciated!!!

  • zha-an
    zha-an Member Posts: 31
    edited October 2014

    hi...i havnt had reconstruction but had similar problems getting my lumpectomy incision to heal. At day 8 I developed eshar tissue which sounds like the yellow tissue you are describing. My doc said it's very common and is basically tissue that grows without blood supply. I was told to use a wet/dry bandage system that helps remove the eshar but you want to do whatever your surgeon or wound care specialist advises. We were unable to get one small section out but didn't worry since a re-excision was necessary to get clean margins. Murphy's Law...three days before surgery the eshar fell off in the shower and on day of surgery I had a perfectly closed incision! Of course all that had to be cut out and I am now day 3 post op and hoping this time will be different!

    talk w your docs to see what they recommend. What worked for me might not be what they recommend. Hoping we both get great healing!

    zha-an

  • clarrn
    clarrn Member Posts: 557
    edited October 2014

    I have two small areas that continue to heal and then reopen.   There is a small amount of clear drainage.   Never gets infected so we just leave it, hoping it would heal after I was done chemo.   No luck so far.   Radiation pushed back 2 weeks to see if it heals.  

  • Theda
    Theda Member Posts: 42
    edited October 2014

    Hi Clarn,

    I had the same problem, waited 7 weeks, it never healed so the implant was removed last Saturday. Now it is healing perfectly. We will give it another shot in 6 months. The other side (the cancer side) healed without any trouble. PS told me that all the problems they see are always with the prophylactic side, they don't know why.

    I had an infection on that side in June and was also "spitting" the internal stitches, I think my body was just rejecting the "foreign" body after the infection. 

    But I heard of other cases where it finally healed after a while, so hang in there!

Categories