What is the Underlying Cause of Areola Necrosis ? - Birmingham, UK

Hi. I have attached some rather graphic shots of...

Hi. I have attached some rather graphic shots of my breast so to hopefully help other people close to my situation, they aren't for the faint hearted so I do apologise. Bottom line is I would like to know what is the cause behind my experience of areola necrosis (superficial kind). its been a painful, infection upon infection and copious amounts of antibiotics, loss of work, emotional and so on.... feel as though my life has been turned upside down! My op took place at the end of jan 2013, I had an uplift and implants all at the same time. I was a 38F with my right breast measuring 3.5 cm larger than the left. It's been something I have been debating doing ever since I was 17! turned 30 and thought I have to sort this out for me... Fed up of feeling self conscious - i simply wanted to be able to take my bra off and see a normal looking pair of boobs! Looking back now if I had of known something to this degree could happen I can honestly say I would never have gone through with it ! I have never known pain like this, the first 3 weeks were excruciating - I was so lucky to have had my man take such great care of me, how anyone in my situation could cope alone is beyond me! I believe the necrosis was missed on my first week check up with the nurse, it was picked up the 2nd week by a diff nurse ..... immediately I saw the surgeon who to cut a long story short basically has been amazing in the sense all after care is taken care of and he acted quickly to save as much as he could. The sad fact is I am left with one breast which due to the necrosis has a large open wound and no nipple or areola! He wants to wait - let it breast heal naturally and at a later date do some reconstruction ... So to hopefully resemble a breast ! The underneath scaring a brilliant but the incision to he right breast ( the good one) I don't feel is very good. I wanted to know what the underlying cause of this type of necrosis is? I don't smoke, they had tested a tissue sample prior to going ahead with the op to write off infection and that was all clear .... I can't help but feel after researching this that it all boils down to the incision around the areola being too deep through the epidermis layer causing damage to the blood flow ? or the pressure of the implants / or the band which had I be worn tightly across the chest to help push the implants into place ?? Appreciate your response
Many Thanks
L

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Most recent photo of left breast

Appreciate my early photos are pretty horrible, this photo shows where I am after 7 months post op .... almost there but no idea what my end result will be - will keep you posted.
L

8 Comments

BoobsL The same outcome happened to me back in December. I think everyone needs to be aware of this possibility even though very rare (less than 1% occurrence). So rare, it's not even mentioned as a possible risk here in the US. I was shocked to say the least. After thoroughly researching this and talking with several friends who are nurses, the causes are one of three: Smoker, extremely overweight and sagging breasts (for instance, after dramatic weight loss) or the doctor's skill. Since the first two did not apply to me or to you from photographs. I have to go with doctor's skill (although excellent reputation). I was on the operating way too long. Hang in there...it may take some time to totally heal and go through reconstruction, but in the end of it all, I'm sure you will be happy with the new uplifted breasts. You are very young and have many years ahead to enjoy your new appearance. If you didn't have it done, eventually you would have back and shoulder pain.
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I am all better, per se. My incision reopening, which was the center of my tummy tuck, has completely closed and in fact I just confirmed with my ps that I would like a scar revision because that sight is in need of it. Hopefully that will occur next month. I don't think at all that you should just give up trying to find out why this happened. Lack of blood flow to the area caused the necrosis, but what caused the lack of blood flow? Too deep into your epidermis is a likely theory for you, not sure about me. I've accepted that it may never be absolutely clear why mine occurred but I will always have an eye out for explanations. You do have a very positive attitude for what you have dealt with though. I am impressed with your spirit and I do hope for the best for you. Take care!
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I am also sorry to hear about your areola not healing. I can't imagine how difficult this has been both physically and emotionally. How have you been able to function on a daily basis? It looks like you're starting to heal, but it must feel like an eternity of waiting for you. Hang in there and I'll keep my fingers crossed that you heal quickly now. Keep us posted and thank you for sharing your story on RealSelf!

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what happens now ? :(

Almost 10months since my op... As you can see its not been an easy recovery process. What I hoped and dreamed for since I was 18 yrs was to feel confident and have a beautiful pair of boobs. 30 yrs old and wish I hadn't gone thro with it. But I'm here now and I would like the best advise you can give me in how u believe this should be dealt with and what next steps you think need to happen. my PS has said he will see it through to the end and do all corrective work necessary to achieve good results. I'm somewhat dubious this will be possible. As u can see even after surgery I still have one breast much larger than the other, the right boob has bad scaring from where the necrosis was and perhaps from the breast being heavy ?? The areola I asked for hasn't been achieved (would have liked smaller and more defined areolas) and directly below the right nipple where I had an open wound for a few months, where it's healed it's left my nipple to not react in the way it did before - dull achy feeling, uncomfortable touch. The left breast is a total write off, but they say they will implement a fake areola/ nipple. I know i will never regain full sensitives and feeling I once had - that's the sadist part of this whole affair but is there light through the end of the tunnel, do these nasty looking boobs have a cat in hells chance of looking good good someday ? Thank u for you comments

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implant position

Also do you agree the implants don't seem to be sitting in the right place ? Positioned submuscular . they seem to sit more to the side ... From the front u would t know I've had implants. he did not achieve the perky / pointy look I had asked for.

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Implant position

Also do you agree the implants don't seem to be sitting in the right place ? Positioned submuscular . they seem to sit more to the side ... From the front u would t know I've had implants. he did not achieve the perky / pointy look I had asked for.

3 Comments

Hi there, I went through a similar situation with my tummy tuck. In my cause, since I do not smoke, my necrosis was caused because I was over weight at the time of my surgery. The more layers of fat the harder the blood has to work to flow to your incisions. Did you ever smoke? I am so sorry you had to go through this, its hard to handle for sure.
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You poor thing! What a nightmare! What size and profile did you get? I need to know before I can answer your questions about them sitting to the side. you have very nice cleavage so I do not think you have a pigeon chest like me. Also it may not hurt to post these questions with pics to the real self PS's.
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im so sorry you have had to go through all of this :( i am 3weeks post op from uplift and unders. this was my worst fear! which surgeon did u have at thg? thats who i went with. i have seen pics on here where the breast have been reconstructed after this has happened so you may still have a good result in the end! as for why you developed nipple necrosis, well theie are many factors to take in to consideration How much tissue was taken away? more tissue more risk smoke? even near passive smokers can cause risk alcohol? 4weeks pre and post op diet? haemaglogin level? sometimes there seem to be minimal risks but necrosis can still happen hope things get better for you xx
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