Q: Dr. Eppley, I had a breast lift with implants 6 weeks ago. I have 3 spots on my right breast where the stitches were sticking out a little bit. A week ago I pulled these stitches out pretty easily and they seemed ok. A couple days ago, they had gotten some puss in them and kind of looked like an open sore. So I put neosporin on them and covered with a band aid. Well, now one of the spots around my areola is split open. It seems to have gotten worse as far as the skin opening up. But mostly just some clear, slightly bloody fluid in it. The other 2 spots aren’t as bad. Just wondering if I should leave everything alone, keep using neosporin and covering with a bandaid, or do I need to actually put a butterfly bandaid on it? I have a stitch slightly sticking out on my left breast but I’m not going to touch it. Is this normal and what can I do to make them heal up and go away.
A: These are very typical spitting sutures that almost always occur anywhere from 3 weeks to several months after this type of surgery with long incisional lines in thin breast skin. They are the result of dissolveable sutures being used in the dermis of the skin. Rather than the body resorbing them , which takes up to a year after surgery, it rejects or spits them out because they are so close to the surface of the skin. They appear as red, fluid-filled, or pussy spots along the incision lines. They confuse and concern patients because they appear long after one thinks they are completely healed. (this does not really occur until at least 3 months after surgery) The best thing, and the only curative technique, is to get the knot of the suture out. In the office, I will either squeeze them like a pimple until the knot pops out or pick out the knot or suture end with a fine pickups. They are easily resolved problems that will have no negative influence on the final scar. These are temporary nuisance problems that are the final hurdle to complete healing.
Dr. Barry Eppley