My Doctor debried most of the dead tissue and he said he will have to do more leaving me with this big hole in my breast. I am so teriffied about the hole also about what will happen next I so want to get back to my life and this is all I can think about; It has really messed me up I want to know the process and Im worried about infection...I so want this over with.
I Had a Breast Reduction on November 13,2012 and in my Right Nipple Areola Developed Nipple Necrosis? (photo)
Doctor Answers (7)
Nipple loss after Breast Reduction
It is an unfortunate, but known complication of breast reduction to have some or most of a nipple to undergo necrosis. Along with debridement and dressing changes you will need the tincture of time. Even though it doesn't look as you would like now it will improve and there are techniques to improve the appearance later. The important thing is to do as your doctor instructs and try to be patient.
Nipple/Areola Necrosis after Breast Reduction?
I'm sorry to see/hear about the complication you have experienced after breast reduction surgery. As you know, it will likely require several more weeks of dressing changes and minor debridement procedures before the wound has completely healed. As time goes on, you will notice that the tissues will look healthier ( with more red tissue and less yellow/brown tissue).
In the longer term, you may benefit from the nipple/areola reconstructive procedures. Patience will definitely be necessary; sometimes multiple “smaller” procedures are necessary to achieve the desired outcome.
Continue to follow-up with your plastic surgeon. Best wishes for a long-term outcome that you will be pleased with.
I Had a Breast Reduction on November 13,2012 and in my Right Nipple Areola Developed Nipple Necrosis?
You need daily wound care and possible debridement surgery to help control the wound opening and necrosis.
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Nipple necrosis after reduction
You do have a wound healing problem. It is best handled with dressing changes that will allow the wound to heal over several weeks to months. Ultimately, you will, most likely, have a very nice result. You must truast the process and realize this will not be permanent.\
Talmage Raine MD FACS
Concerned about nipple-areola necrosis following a breast reduction
It is understandable that you are quite anxious and fearful about the blood supply issues and, therefore, the ultimate appearance of your nipple-areola complex. From you photos, it is difficult to determine the exact extent of the necrosis but it does appear that you do have a considerable amount that is quite viable.
The approach that it seems that your doctor is taking is the right one. Give this time to heal on its own and mature. Patience is a virtue here - and can lead to a better outcome. Intermittent debridements can be done during this period of time. Ultimately, you may be left with a far better outcome than you may be anticipating right now. If there are significant anatomic deficiencies long term, there can be ways to obtain a far more acceptable result.
Nipple necrosis after breast reduction
it appears the nipple has been devascularized after breast reduction. This can occur is too much tissue was resected or the nipple areola complex was roughly handled during the procedure. The proper thing to do is to dress the wound with silvadene and debride the obvious necrotic tissue. After everything heals, which can take months then you will need to have your nipple areolar reconstructed. This is similar to many women who do not have a nipple areolar complex after mastectomy. You will need to discuss this with your Plastic Surgeon when the time comes.
Management of Nipple Necrosis after Breast Reduction
The short answer is that there are a multitude of ways to reconstruct a deficiency in this area. Your plastic surgeon is managing the necrosis appropriately. It is a bit difficult to tell from the picture how much of the areola is left and whether the nipple is still present. Once the the scar is fairly mature (after 3 months or so), you will have a better idea of what to do next.
If only a portion of the areola has been removed, it may be possible to readvance the remnant areola in such a way as to produce an entirely normal looking areola. It is unlikely that you will get an infection if the area is kept clean and managed appropriately. Even if you need reconstruction of the entire nipple areola complex, this is done everyday for breast reconstruction patients after mastectomies.
This is frustrating and requires patience but can be remedied.
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.