Areolar Necrosis After Tubular Breast Correction, Breast Lifting and Breast Augmentation

10 days ago (02/05/11) I had a breast lift with augmentation, after 3 days post op, noticed blood in one of my breast, now I have a very dark skin in one areola. Doctor says that I will be fine and skin will grow again and will be normal, my main question is how will be the areola after few months, what can I do, do I need a second surgery to correct it, areolas of both breasts are different in shape, dimension and position, this will be corrected with time?

Doctor Answers (11)

Areola necrosis after breast surgery

+2

Everyone would agree you have lower areola necrosis. The question is how deep is that necrosis and what is the cause of the lack of blood flow leading to the necrosis. The more superficial it is the less scarring and residual you will have. Given the dark color it is most likely full thickness. You need to be watched closely with regular visits to your surgeon because if you just ignore this you are at risk of having an exposed implant that will have to be removed. If you cut out the dead part you may have difficulty closing the resulting wound and again risk implant exposure. If the decreased blood flow is due to tension or a hematoma those should be addressed as soon as possible.

If you get the situation under control and it heals without exposure of the implant the resulting scar cannot be predicted at present. Some of these heal with out the need for further surgery. Some only lose areola color which is treated with medical grade tattooing. Some require surgical reconstruction of the areola by one of numerous available techniques.


Los Angeles Plastic Surgeon

Areolar healing problem

+2

Based on your photos, you have a small degree of necrosis.  With local wound care and close follow-up with your plastic surgeon, the area should heal well.  It is hard to predict what the final result will be like.  However, most incisions on the breast/areolas heal well over time.  Even if your areola heals with some widened scar, this can be corrected at a later date.  But you should wait at least 3-4 months before attempting another surgery. 

Sugene Kim, MD
Houston Plastic Surgeon
4.5 out of 5 stars 35 reviews

Areola healing issue

+2

It is hard to say what the long term appearance of the areola will be.  Follow your doctor's instructions. If if doenslt heal well and loses color it can always be tattooed. Sometimes a scar revision can help.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

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Areola necrosis

+2
All complications are emotionally devastating to patients. It is normal to have a lot of questions. As you see from the previous responses these complications do happen and often get better with just observation and wound care. Stay in close contact with your PS and ask questions.

Delio Ortegon, MD
San Antonio Plastic Surgeon
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Areolar necrosis after surgery

+2

The nipple/areola complex is extremely durable and will heal despite injury to its blood supply. Obviously if the injury is too severe, then this does not apply.  The main thing is to make sure you do not have an underlying hematoma that is adding pressure to the areola and making things worse. If so that would need to be drained. You will need to be watched carefully as the implant is at risk.  These processes can take 2 to 3 months to heal, but many times they do not need any major revision.  There can be loss of pigmentation and some contour irregularities.  Hang in there and keep your doctor posted!

Francisco Canales, MD
Santa Rosa Plastic Surgeon
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Areolar Necrosis After Tubular Breast Correction, Breast Lifting and Breast Augmentation

+2

Thanks for trying to post your photos. In my opinion based on the limited info I feel in 6 months you will need a revision surgery. Sorry, From MIAMI Dr. Darryl j. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Areolar necrosis or loss after a breast lift

+2

Areolar loss is a rare risk after breast reduction, and should be even more unusual after a breast lift, yet for some reason the circulation to the nipple has been compromised. As you have had a vertical breast lift your breast was not 'tuberous', and it is clear from your photo that the implant is very full and projecting, more than the areolar skin could handle. The areola will heal. The result is likely to be an area where the pigmentation has been lost and the nipple is out of round. Stay in close contact with your surgeon.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

Skin necrosis and breast augmentation

+2

When skin dies (necrosis) in an area after surgery, especially in an area that is not too big, the body usually does a pretty good job of healing itself. Sometimes the scars are acceptable and sometimes not.  If you try and fix things too quickly, it can make them worse.

Healing can take a couple of weeks to a couple of months depending upon how large the area is.

Just stay in close contact with your surgeon. Implants will continue to reposition as well over the first couple of months and with that breast shape and areolar position change some as well.  Hopefully for you into something more symmetric.

Byron D. Poindexter, MD
Reston Plastic Surgeon
5.0 out of 5 stars 5 reviews

Areolar necrosis

+2

Areolar necrosis is a recognised complication following this surgery.  It looks bad now, no one wants to see a black areolar, but it looks like you have only a rim necrosi of your areolar and this should heal fine, without the need for further surgery.  It will leave a more unsightly scar in the area than you would have liked, but it is in the inferior part of the areolar, so you won't be able to see it when you look down.

All in all, don't lose heart, it will look much better in the long run.  Your surgeon can address any differences in size, shape and position of your areolae once it has all healed.

Jonathan J. Staiano, FRCS (Plast)
Birmingham Plastic Surgeon
5.0 out of 5 stars 8 reviews

Areolar necrosis looks worse now than it will

+1

Don't despair.  With proper wound care and time the blackened area will heal and usually the scar looks much better than initially feared.  It is emotionally hard to take, but patience will pay off.  You may need a scar revision later, but it can usually be done with local anesthesia.  This complication is more common when breasts lifts and augmentations are combined.

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.5 out of 5 stars 11 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.