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complications and concerns

Contact your surgical team promptly if you develop new or worsening symptoms during recovery. Follow the specific instructions they provided, because expected symptoms vary by procedure and stage of healing. Seek emergency medical care for difficulty breathing, chest pain, fainting, confusion, uncontrolled bleeding, or another rapidly worsening or life-threatening symptom. This page cannot determine whether an individual symptom is normal or requires treatment.

Signs of Infection:

Possible signs of infection can include:

  • Fever
  • Spreading redness or warmth
  • Worsening pain
  • Pus-like or foul-smelling drainage
  • Increasing swelling
    • Some redness, swelling, discomfort, and drainage may be expected during healing, so contact your surgical team if you are uncertain or notice a significant change.

Hematoma: an accumulation of excess flood underneath skin

A hematoma is a collection of blood beneath the skin. It may cause increasing swelling, firmness, pain, bruising, or noticeable asymmetry. A rapidly expanding hematoma can require urgent treatment. Do not decide based on size alone whether it is safe to observe; contact your surgical team for guidance.

  • Sign of hematomas: hard, swollen, painful area with color change around incision site
  • Small hematomas are likely to clear up on their own
  • Large hematomas may require additional drainage and rarely additional surgery

Nipple/Areola complications (NAC):

  • Loss of Free Nipple Graph (FNG)
    • May not take or survive healing process
    • Can result in partial or complete loss
    • Nipple tattooing is a popular option once area is fully healed
  • Pigmentation Changes
    • NAC color can become lighter or darker
    • Not necessarily a cause for concern unless persistent redness or swelling
  • Lack of Sensation
    • Partial or full loss of sensation in the NAC
    • Some sensation can return over time

Seroma:

A seroma is a collection of fluid beneath the skin. Some resolve without intervention, while others require evaluation or drainage. Contact your surgical team if you notice a new fluid-filled area, increasing swelling, discomfort, drainage, or asymmetry.

  • Drains can prevent pools of seroma fluid called seromas.
    • Small seromas are usually absorbed back into the body over time
    • Large seromas require being drained.

Excessive bruising:

  • Blood vessels can be damaged during surgery, causing bruising
  • Certain medications can affect blood clotting (i.e. Aspirin)
  • Use cold compresses in 10-to-20-minute intervals to reduce bruising
    • Do not place ice or a cold compress on the surgical area unless your surgical team specifically approves it.
    • Reduced sensation after surgery can make temperature-related skin injury harder to detect, and postoperative instructions vary by procedure.
  • Most bruising will resolve on its own
    • Bruising can go from dark blue or purple to a yellow or green color as time progresses

Asymmetry/Appearance:

  • Uneven appearance or contour of chest due to healing, surgery technique, and natural body asymmetry
  • “Dog-ears” are small folds or areas of excess tissue that can occur near the ends of an incision. Their appearance may change as swelling resolves and the scars mature, but some persist and may be addressed through revision. Ask your surgeon when the final contour can reasonably be evaluated.
  • Your chest will not look exactly how it will after several months of healing
    • Be patient and note any abnormalities
    • Allow for initial swelling to subside before assessing
    • Follow post-op care plan to promote even healing
  • If necessary, it may require surgical revision to achieve desired appearance