Managing Breast Inflammation: Solutions and Surgical Options Explained

Regarding mastitis..?

Hello...
About eight years ago, I underwent drainage due to mastitis.
Before the mastitis, my nipple was not inverted, just somewhat flat, but after the inflammation, it became inverted.
In the following three years, I experienced four more episodes of inflammation, but since then, I haven't had any more issues, so I haven't paid much attention to it.
However, I noticed that the scar area seems not to have fully healed, as there is a very small hole, and I'm wondering if this is what is referred to as a fistula!? Two to three months ago, the scar area became inflamed and developed pus, which later turned into an open wound.
At that time, I changed the dressing myself and let it heal slowly.
I would like to ask if there are any solutions to prevent further inflammation! Additionally, is there a need for plastic surgery? If surgery is necessary, should I consult a plastic surgeon? Also, could you please let me know if health insurance covers this? Thank you!

Doris, 20~29 year old female. Ask Date: 2004/12/20

Dr. Yang Jinfa reply Breast and Thyroid

Hello, mastitis often recurs, especially when there is rapid healing of wounds.
Your symptoms are consistent with this, and this time it is a recurrence of mastitis.
It is best to apply a medicated dressing to prevent the wound from healing too quickly.
If necessary, debridement surgery may be required.
Inverted nipples can be improved through surgical correction, which can be performed by a general practitioner.
Please note that this procedure is not covered by health insurance, as it is considered non-essential surgery.
Thank you for your inquiry.

Reply Date: 2004/12/20

More Info

Managing breast inflammation, particularly after experiencing recurrent issues like mastitis, can be quite challenging. Your history of breast inflammation and the subsequent changes to your nipple and scar tissue indicate that you may be dealing with complications that require careful evaluation and management.

Firstly, it's important to understand that recurrent breast inflammation can lead to structural changes in the breast tissue, including the formation of scar tissue and possibly a fistula (an abnormal connection between the skin and the underlying tissue). The small hole you mentioned could indeed be a remnant of a previous infection or a fistula, which can sometimes occur after repeated infections or surgeries.
To address your concerns about preventing future inflammation, here are several strategies:
1. Regular Monitoring: Keep an eye on any changes in your breast tissue. If you notice any signs of inflammation, such as redness, swelling, or discharge, seek medical attention promptly. Early intervention can prevent more severe complications.

2. Hygiene Practices: Maintain good hygiene, especially in the breast area. This includes regular cleaning and ensuring that any wounds or openings are kept clean and dry to prevent infection.

3. Medical Evaluation: Given your history of recurrent mastitis and the current issues with your scar, it would be wise to consult a breast specialist or a surgeon who specializes in breast conditions. They can perform a thorough examination, possibly including imaging studies like an ultrasound or mammogram, to assess the condition of your breast tissue and any underlying issues.

4. Surgical Options: If the scar tissue or the small hole is causing ongoing problems, surgical intervention may be necessary. This could involve excising the scar tissue or addressing any fistula that may have formed. A plastic surgeon or a breast surgeon would be the appropriate specialists to consult regarding potential surgical options.

5. Plastic Surgery Considerations: If you are considering cosmetic surgery to improve the appearance of your breast or to correct any deformities caused by the inflammation, a consultation with a board-certified plastic surgeon is recommended. They can discuss options such as scar revision or reconstructive surgery. In terms of insurance coverage, it varies by provider and the specific circumstances of your case. If the surgery is deemed medically necessary (for example, to correct a functional issue rather than purely cosmetic), there may be a possibility for insurance coverage.

6. Preventive Measures: Depending on the underlying cause of your recurrent mastitis, your doctor may recommend lifestyle changes, such as dietary adjustments, stress management techniques, or hormonal evaluations if they suspect hormonal imbalances could be contributing to your issues.

In conclusion, managing breast inflammation and its complications requires a multifaceted approach. Regular monitoring, good hygiene, and timely medical intervention are key to preventing recurrence. Consulting with specialists will provide you with tailored options for treatment and potential surgical interventions. Always ensure that any surgical decisions are made with a clear understanding of the risks, benefits, and expected outcomes.

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