Published on 7 July, 2021T-junction breakdown is one of the most common complications following breast reduction or breast lift surgery. This occurs when there is delayed wound healing in the area where the vertical and horizontal suture lines meet, at the base of the breast.This area bears the most tension, and the most compromised blood supply, following surgery and is therefore most prone to breakdown in the superficial skin layers.T-junction breakdown presents as a small opening in the incision line, sometimes with redness and ooze (examples, pictured right).Although this delayed healing is typically short lived and resolves with minor wound management, everyone hopes they’ll have the ‘perfect’ recovery and so it can be distressing for patients to have healing setbacks.When noticed early and managed well by the patient at home in conjunction with their clinic nurse, the wound heals quickly and results in only minor scarring, which improves over time. Although sometimes unavoidable, prevention is always better than cure. There are a few simple steps you can take to help your surgical wounds to heal in the t-junction area: Suture lines like to be dry. Showering is okay 24hrs after your surgery, but it is important to get your tapes extra dry afterwards. We recommend pressing out any excess water from your tapes with a clean towel, then using a hairdryer set on cool, to dry off the tapes before replacing your garment. Always pay attention to your tapes in the first 6 weeks following your surgery. Although some signs of weeping through the tape is normal, if you have more than a 5-cent piece sized area of weeping, you should be in contact with your clinic for advice. Customised post surgery taping and massage advice will be given by your post op care team dependent on how your incisions are healing. Follow them closely and stay in touch if anything changesSilicone tape is great, but suture lines must be 100% healed before silicone tape can be used. Placing silicone tape over even the smallest of wound breakdowns can make them larger. Small breakdowns can occur up to six weeks following your surgery, so please don’t become complacent. Any sign of weeping on your garment, check your suture lines. Always be in touch with your clinic if you are concerned. Pay attention to how you are feeling and get in touch with the clinic if you notice any signs of infection (these are detailed in your post op instructions). Don’t smoke; this is one of the biggest factors in delayed wound healing. Eat well; good nutrition helps support your skin healing and overall recovery. Sugary, salty or processed foods can contribute to overall poor health, fluid/swelling retention and difficulty fighting infections that can opportunistically set up in the open t-junction wound. Consult your GP or a nutritionist if you need assistance with your diet to ensure the best possible recovery. What should I do if I have a wound breakdown? Even with diligent care, t-junction breakdowns can happen. If this is the case, your post operative plastic surgery nurse will be skilled and experienced in the best way to manage your incision. They will review the area and provide you with detailed instructions. It is important to follow these closely and speak to your nurse if you are confused or have any questions. The area needs to be kept clean and dry. Do not apply any occlusive or waterproof dressings. Protect the area from rubbing – and absorb weeping by using a cotton round/makeup pad taped across the area. Remove the pads gently in the shower, making sure not to pull the pad away if it is stuck – this only removes the healing that has occurred that day – but rather soak the pad off under the warm shower water. Betadine solution can be dabbed on to the area daily, this help keep bacteria away while helping dry the area out. In time, your breakdown will become a small scab and will heal from the inside out. T-junction breakdowns are rarely re-sutured as it can cause more scarring and delayed healing. Will this area scar much worse than the other sealed areas of scarring? It is likely that your scar will be more prominent in this area, although that will depend on your natural predisposition to scarring. It is difficult to predict what your scars will look like, but over the subsequent 24 mths most patients find they mature, soften and lighten significantly. If your surgeon thinks you would benefit from scar revision down the track (6-12 mths at least after surgery, to give the area time to heal) this can certainly be explored, but is not usually necessary as the body usually does a good job of naturally optimising the residual scar over time. Non surgical options such as steroid injections, laser and microneedling are also available. What if I see a suture through the wound? It is not uncommon to see exposed dissolvable sutures in a t-junction breakdown. This is not cause for alarm, but we do like to trim these away. Once the dissolvable suture is above the skin’s surface the wound does not like to heal around them, and therefore removing them is best. Please contact your clinic to see your nurse. With diligent home care, good health, and monitoring from your plastic surgery nurse, wound breakdowns will heal. Stay in regular contact with the clinic and don’t hesitate to book additional post operative appointments in to support you through this healing period.All procedures carry risks and a recovery; visit the breast reduction page to learn more.
