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Fat Necrosis Pain Staph 9 years after Breast Reduction

I had a breast reduction in 2001. I had a noticeable amount of scar tissue on the underside of my left breast. It has been increasingly bothersome in the past 2 years. I had a hysterectomy a year ago & developed a case of Staph (Kept ovaries).
I've been dealing with a sinus infection &been on antibiotics for seven weeks. 3 weeks ago, my left breast was REALLY bothering me. Took my bra off to find a large 'hot spot' that felt very 'fluidy' underneath. (exactly how the Staph presented itself on my leg). I saw my Infect. disease doc's partner who had me start a PIC line & Cubicin immediately. He said I needed to see the Plastic Surgeon that did my reduction ASAP. Explained he had relo'd out of state. Infectious Disease doc said I needed to find 'the best' breast reconstructive doc I could find.
I get an ultrasound/digital mammography done. Radiologist was rather concerned - said bad case of 'fat necrosis'. See a 'the best breast reconstructive' doc around. He takes uses a syringe bigger than a turkey baster to get some samples. Said it was 'oily' and he wasn''t sure if he'd even gotten it - needed an ultrasound to confirm. But since I've been on antibiotics so long, that they wouldn't expect to see anything. This doc doesn't understand how screwed up the last incident was - 8 weeks of IV antibiotic infusions + 3 cleanings.

Good news, the size of the 'hard lumps' in my breast are down significantly, but the pain (deep-feeling) is still continuing. I certainly don't want to have unnecessary surgery. I understand it could potentially create more scar tissue. But I assume that having dead tissue isn't a good thing either. I feel like I'm between a super-aggressive doctor (infectious disease) and a very low-key doc (plastic surgeon). I'm 40 and in good health except for immune issues.

Thoughts? I tend to lean toward being more cautious - rather get this taken care of but... another surgery!?!?
1 Responses
242582 tn?1193616720
MEDICAL PROFESSIONAL
Surgery would be indicated if your symptoms persist and are disabling, or if there is recurrent infection in the area.  with signs of improvement and reduced symptoms, it seems that careful follow-up without surgery might be appropriate.
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