[SavageGlow]

A 25-year-old black female who underwent a bilateral breast reduction at another provider four weeks prior to arriving at the clinic presented with a chief concern of a foul odor coming from the areolas (Figure 1). The patient had a body mass index (BMI) of 29.5, was originally an E cup, and had a reduction of over 1 kg per side per the previous provider. She had no other past medical history, no other surgeries, reported no allergies, no current medications, and no other substances such as ethanol, smoking, or recreational drugs. Physical exam was significant only for eschar completely overlying both areolas (Figure 2). A diagnosis of bilateral NAC necrosis was made, and the subsequent treatment plan followed.

Treatment began over the course of three months in the outpatient with partial debridement of eschar every two to three days. Further debridement was performed, excising fat necrosis extending to the muscle. This took place over the course of three weeks with patient education on wet to dry dressing application and change. At 21 days from the first encounter, debridement was combined with the breasts being packed with hypochlorous acid (HOCl) (PhaseOne, Integrated Healing Technologies, Franklin, TN) and wrapped. Wet to dry dressings were changed at follow-up appointments every two to three days by the staff and at home daily by home health care. During these appointments, healthy granulation tissue was noted (Figure 3). The patient was instructed to shower daily with antibacterial soap and cover wounds with dry gauze. Pictures were taken at 157 days post-procedure showing healed areolas (Figure 4).

[Sa Bal]

so her nipples are like old ground beef but she waits for the smell to get too bad to see a dr? wild

[mintycbo]

Bottom pic is something out of hellraiser.