Have you ever seen a nipple graft do this before?

The indentation is most likely from a tie over dressing that was applied and will fill out in a week or so. The graft does not look black but may have some loss at the lower portion. The dressing changes is the way to proceed and in time it should heal reasonably well. Minor scar revisions or tattooing may have to be done later on.

FTM Top Surgery can leave noticeable scars on the chest. Our office
specializes in Hidef Scar Protocols to help correct scars from FTM Top
Surgery; including Vbeam laser, fractional RF and Laser, scar modulation
RF, topical scar protocols that do not require surgery, and scar
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Best, 
Dr. Karamanoukian
Realself100 Surgeon

If you recently underwent Top Surgery,then it is still very soon into your #healing. Therefore, your incisions and #nipples will go through a maturation #process. For the first few months they will be red and possibly raised and/or firm. As the scar matures, after 6-12 months, it becomes soft, pale, flat, and much less noticeable. You may experience numbness, tingling, burning, “crawling”, or other peculiar sensations around the surgical area. This is a result of the #healing of tiny fibers which are trapped in the incision site. These symptoms will disappear. Some people are prone to keloids, which is an abnormal scar that becomes prominent. If you or a blood relative has a tendency to keloid formation, please inform the doctor.
Bruising and #swelling are normal and usually increase slightly after the removal of any tape or foam. The bruising will decrease over 3-4 weeks, but may last as long as 6 weeks. The majority of the swelling will be gone within the first 3-4 weeks. However, it may take 6-9 weeks to disappear completely. Also, as you heal, the area may feel “lumpy” and irregular. This, too, decreases with time, and massaging these areas will help soften the scar tissue. The #compression garment helps reduce the swelling, and the longer it is worn, the more quickly you will #heal. It can also assist in the retraction of the skin. If you have any concerns about #healing, its best to ask questions of your surgeon or their nursing staff.

Thanks for your question and congratulations on your surgery. Based on your photo, it appears that you have some degree of loss of the nipple graft, but the majority looks ok.  It is not uncommon for the nipple grafts to  look a bit scary while they are healing.  As far as the "collapse,"it is difficult to say without an exam.  How much the nipple protrudes is directly related to the tissue below it.  Sometimes the dressing used to secure the graft can cause some compression of the underlying tissue.  If its related to the dressing, my experience is that it usually resolves. I would follow the advice of your surgeon and apply ointment and wait for complete healing before making any assessment of the final result. I have seen nipples that look like that recover quit nicely. If after adequate healing there is still an area of depression beneath the nipple, it can be addressed with fat grafting.  Best Regards.

It looks to me like the graft did not take, all you can do is let that granulate in and then consider nipple reconstruction at a later date. Jane

It appears that the whole nipple/areolar graft did not take successfully. The picture suggests that there was insufficient dermal bed to support it.