Can post-surgical adhesions be fixed?

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MTwoman asked:

I was wondering if anything can be done about post-surgical adhesions. My lovely surgeons did multiple surgeries (for my mastectomy and subsequent reconstruction) as I threw a hematoma after my lumpectomy. They were trying to limit how many scars I ended up with, so they used the same incision site for my drain tube for each surgery. What I've ended up with is a scar that has adhered to the tissue underneath and, so, the skin doesn't move freely or lay flat. This leaves me with a bunch of skin and tissue that sort of sticks off the right side of my chest close to my armpit and looks pretty funny with any sleeve-less top/tank top or bathing suit. Can anything (short of an additional surgery) be done? Thanks so much!

Answer:

There are some things that can be done that can improve scar tethering/adhesions short of surgery. First-line treatments can include silicone gels and sheeting for the external feel/appearance. Combine this with massage to the area to improve the mobility of the scar. Physical therapy can help to improve range of motion to the shoulder as well as alleviate some of the discomfort. However, I suspect that you would do best with an additional surgery. We often extend incisions towards the armpit and bra line to remove excess axillary skin and refine the outer breast shape. If you have cording (bands extending from the arm to the chest wall) the cords can be released at the same time. Drain sites can be excised and resutured to correct tethering as well. Seek out reconstructive surgeons specializing in breast reconstruction and offering implant and autologous/flap reconstructions.

— M. Whitten Wise, M.D.


M. Whitten Wise

M. Whitten Wise, M.D.

Dr. Wise is part of the reconstruction team at the Center for Restorative Breast Surgery in New Orleans, Louisiana. Learn more about Dr. Wise.


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