2 days after lift & augmentation my right nipple turned black & was a total scab. Can this heal & look normal over time? (photo)

I too am sorry this rare (<1% of patients, unless you are a smoker or exposed to second-hand smoke, where the risks jump to 15-20%) complication has occurred. This is dead tissue due to lack of circulation. The depth of the skin loss is impossible to determine, but those of us who have seen this know that a "normal nipple" is not "under the scab." The scab is the dead skin, possibly partial thickness, but likely full-thickness based on your photos.The good news is that once this scab separates (or is debrided surgically under local anesthesia), the resultant wound will heal, and the scar can be replaced with a reconstructed nipple/areola complex, just as we do for breast cancer/mastectomy patients. The reconstructed nipple/areola complex is not "original equipment" but is your own living tissue that looks almost identical to the opposite side.For now, your surgeon should be following your progress closely. This is neither your surgeon's nor your (unless you are a smoker) "fault," and this will heal over the next few weeks. Silvadene, Nitrofurazone, or simple wound care (clean and dry is good; daily antibiotic ointment can cause allergic reactions that can worsen scarring) are all appropriate options. Follow your surgeon's advice, and be aware that surgical debridement (removal of the dead skin and scabbing) can actually hasten and improve healing when performed appropriately and at the proper time.Once the scarring is soft and all wounds healed and supple, reconstruction can be discussed. I'd recommend waiting for at least 6-12 months. The present wound will heal over several weeks with ongoing care. Hang in there and enjoy what will eventually be a fabulous result, albeit with an unexpected "detour." Best wishes! Dr. Tholen

I am so very sorry you have this severe complication of complete nipple/areolar necrosis. Only reconstructive surgeries can repair this issue... 

Thanks for the question and photos.  I'm sorry you are having this problem.  Even in the hands of the world's best Plastic Surgeon, there is a risk of nipple death after a breast lift, especially with implants.  It appears that you have partial or complete loss of your right nipple/areola.  It is best to let the scab fall off on its own, that way any living tissue isn't removed.  This will take several weeks to heal from, but the end result may still be acceptable in time.  I would stick with your Plastic Surgeon and work together for the best possible outcome.  Best wishes!