The curious case of milk collection under skin graft over the breast: Lessons learned!

Raw area on the breast, especially when it is lactating, can lead to complications, including hyperprolactinemia and development of milk fistulae. A 25-year-old female presented with raw area over the left breast after 2 months of childbirth. She had history suggestive of necrotizing disease, which had primarily been managed elsewhere with debridement and dressings. We excised the raw area and applied split thickness skin grafts with minimal meshing. Bulky dressing prevented breastfeeding. On postoperative day 3, there were blebs containing milk underneath the graft. The blebs were drained and oral cabergoline was administered for 3 months. The skin graft healed well. If expression of breast milk is not possible then suppression of lactation should be considered before definitive cover of the raw area of breast.