It's always frightening when you can't get in touch with your surgeon, but just a little drop of blood is very unlikely to indicate a serious problem. I think that your suggestions are exactly what I would recommend: stop massaging, clean and dress the incision daily, and put your bra back on. If you're in Tennessee, I'd be happy to see you today (obviously for no fee) - it's very unlikely you need anything done, but I hate to think of you feeling like something is going on and nobody cares. Good luck!!

Published on Jul 11, 2012

I will typically discourage any aggressive physical activity for 4-6 weeks postoperatively. That being said, a small amount of spotting is not necessarily a cause for panic, especially in the early postoperative period. However, without an exam or photos to evaluate, it is difficult to offer any reliable advice.

In my practice, strict support garment usage is encouraged. I do not require massage unless obvious and persistent malposition is noted. Any open wound should be cleaned and dressed daily.

Most importantly, if you have any concerns, see your board-certified plastic surgeon (ABPS) as soon as possible.

Published on Jul 11, 2012

Was your breast being handled during sex? Most plastic surgeons advise our patients not to have the breasts handled by others for several weeks; the incisions need to be fully healed before there is external manipulation other than surgically-instructed massage and wound care.

It is a sad statement that your out-of-town surgeon is of no help - he/she took your money for surgery and the office should provide you appropriate guidance for followup. If you see a local plastic surgeon where you are, you will certainly be expected to pay consultative and followup fees but you should be seen no matter what in order to make sure the wound heals properly.

Published on Jul 11, 2012

It sounds as though it is under control at the moment based on your comments. I would recommend continuing to monitor the area and follow the post-op instructions give by your plastic surgeon.

Published on Jul 11, 2012

I would recommend applying a clean dressing and make an appointment with a general surgeon.

Michael Eisemann M,D.
Plastic Sugeon
Houston,Texas

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Published on Jul 11, 2012

I would have your wound evaluated sooner than later. Strenuous physical activity is to be avoided after breast augmentation for usually three weeks. By three weeks, your wound tensile strength is only 20% of your intact skin. Bleeding from your wound is clearly indicative of loss of wound integrity. Depending on your incision placement and body habits, this open wound could indicate what kind of implant space you have. If so, your implant can get infected and will need to be removed. I close breast augmentation incisions in separate multiple anatomical layers, so it can tolerate a superficial injury and not jeopardize the implant as much. I don't know what type of wound closure you have. While your disrupted wound may go on to heal, if it communicates to your implant you are subject to a higher risk of capsular contracture.

Regarding having a surgeon who is completely unavailable, I think that is unacceptable. A reputable surgeon should have a coverage arrangement with a colleague, especially for planned times out of town.

You at least should have a physician evaluation of your bleeding 10-day old wound. Cover the wound with antibiotic ointment three times per day and use a gauze dressing or panty shield, which you should change three times a day.

Look in your area for a board certified plastic surgeon and see if you can get an appointment today or tomorrow. Hold off on further activities until you've healed enough to tolerate them.

Published on Jul 11, 2012

Thank you for your question. Generally, I ask patients NOT to raise their blood pressure for the first 2 weeks after surgery to reduce the chance of bleeding. You need to speak with your surgeon and/or his staff for advice - they will be your best resource.

Best wishes.

Tom Pousti MD
www.PoustiPlasticSurgery.com

Published on Jul 11, 2012

I tell my patients to refrain from sex or anything that would raise your blood pressure for bleeding, or a trip back to the operating room could occur! I have them wear the bra I give them for a two-week period and tell them not to massage their breasts until I tell them. For my out of town patients, as well as in town, I provide them with my cell phone so they can contact me at any time with questions they may have. Also, do complimentary initial FACETIME or Skype consultations!

Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery
Newport Beach, San Francisco,Miami, Italy, Anguilla
949.640-6324/1.888.234-5080(Ca)
FAX- 949.640-7347
Website: http://www.surgery-plastic.com
Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine)
Orange County’s Physician of Excellence/America’s Top Physicians/Top Doctors
Plastic Surgery- 2005-2017
President,American Society of Bariatric Plastic Surgeons
www.ASBPS.org
Organoderm Skin care/ScaRxTape

Published on Jul 11, 2012

You should never massage your breast implants. There is no need to. Implant massage has been proven to neither prevent nor treat capsular contracture, and is not necessary for normal healing. Don't worry about the spot of blood.

Published on Jul 11, 2012

Don't panic. There can be small amounts of drainage/blood just from the wound that is healing where the implant was placed. Clean with soap and water and apply a clean gauze daily to thwart any further drainage. You can simply hold the gauze inside your bra to avoid tape irritation.

Published on Jul 11, 2012