Best Treatment for Necrotic Areolas, Nipples and Attached Scar?

6 wks ago full breast reduct. w/ liposuc of 500cc+ each side and had hematoma on right breast 9 hrs later fixed w/ suction of area, drain cleaned; hemat. killed right areola now is necrotic. Dressings removed, likely affected left areola/nipple, also went necrotic. What is best tx for necrotic scar, keep dry or moist (daily saline + jelonet), how long to heal? Feel both nipples. Rev surg/tattoo eventually I guess. Also massage of attached scar not helping, best tx? Mid 50s. Monitor weekly? Thanx

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5 Doctor Answers | Asked by W8297 in CA

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Breast Reduction Complications including Loss of Nipple and Areola

Hi W8297 in CA, I'm obviously very sorry for the problem you're having. Tissue loss, including the nipple and/or areola, are recognized potential complications that are, fortunately, very rare, but when they occur to you they don't seem so rare. I would generally advise conservative management at this stage, with moist dressings and/or antibiotic ointment until the eschar (thickened, black tissue) has separated. I would then maintain a non-adherent dressing... more

Nipple loss after breast reduction

That is a really unfortunate outcome, and I'm sorry you're going through that! Partial or complete nipple loss is a recognized potential risk of breast reduction, but thankfully uncommon. It is not clear to me what technique of reduction was used based on the photos. It looks like you have incisions extending on either side of the nipple areola complex. At this point, based on the appearance in the photos, I would recommend antibiotic ointment to the black and yellow dry areas until... more

Necrotic nipple

I am sorry that you are having these difficulties, but this is the time when you follow closely with your surgeon and follow his/her instructions.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Nipple loss after breast reduction

Fortunately nipple loss after breast reduction is uncommon, though for all surgeons in practice long enough, we know that the risk is a real one. I cannot recognize the scar pattern, vertical or 'T' from your photo, though we often debride conservatively when nipple loss occurs. We like a saline moist dressing until the degree of loss 'declares' itself and then clean the area and continue moist dressings until the wounds close. Often there is more recovery than... more

Best Treatment for Necrotic Areolas, Nipples and Attached Scar

This is an unfortunate occurrence that you are going through. Please listen to your surgeon as you go through the delayed healing process. Wet to dry saline dressing may be sued or antibiotic topical such as Silvadene is frequently used. After a period of time your surgeon will be able to see more clearly what is left and what is missing and determine which route to take on reconstruction of the nipple areolar complex.