Areola and Nipple Have Died - What Happens Now?

After a breast reduction and lift, my areola and nipple have died. what should happen now. I go back to my Dr. tomorrow.

Doctor Answers 11

Nipple areolar slough

This is a known complication of breast reduction surgery, more likely to occur in smokers or patients with long pedicles. If the nipple cannot be saved, your plastic surgeon will be able to perform nipple areolar reconstruction in several months. This will be covered by your insurance. Until your doctor tells you definitely that the nipple is totally lost, don't rush to conclusions. He may be able to debrief the area and ultimately save the nipple.

New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Nipple loss after reduction

Right the most important thing to do is do get with your surgeon.  You will likely need that area debrided to healthy tissue, determine the extent of the problem, and develop a plan for reconstruction.  As noted above, this is an uncommon, but well-known, complication of reduction/lift.

Michael L. Spann, MD
Little Rock Plastic Surgeon
4.4 out of 5 stars 31 reviews

Nipple reconstruction

If you have lost your nipple, you  have to let things heal in for now and then you can have a reconstruction at a later time.  Follow closely with your doctor.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast reduction

This is a complication that can happen. A reconstruction can be performed after things have healed. You should see your physician frequently

David L. Abramson, MD
New York Plastic Surgeon
4.1 out of 5 stars 12 reviews

Options after nipple loss

I just posted the answer though I will repeat as the problem is a huge worry for all. Nipple loss after a breast reduction and breast lift is uncommon, but it does happen. It is unusual to lose the entire nipple, and time and patience should allow the area to heal in and to soften. The center and part of the areola is likely to persist and after healing a skin graft can be used if needed to provide structure and texture, and tattoo is able to blend and restore the color lost to scar. Again, the results can be quite nice and should be covered by insurance.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Breast reduction

If your nipple and arealo have turned hard and black, they will need to be removed and ultimately, rebuilt.  There are many reasons for a darkened nipple, however, and your surgeon will be able to tell the difference between them.  Some are normal and will turn out fine (bruising, for example).  It's good that you are going to see him tomorrow.  Good luck!

Robert K. Sigal, MD
Reston Plastic Surgeon
4.4 out of 5 stars 21 reviews

Areola and Nipple Have Died - What Happens Now?

This is a known complication of breast reduction surgery.  Initially the nipple areolar complex should be treated with wet to dry dressing or Silvadene and allow to settle down.  After the acute phase is over then your surgeon will discuss reconstruction of the defect as needed.  It is important to work with yur surgeon to resolve this complication.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 109 reviews

Breast Reduction - Nipple/Areola Loss; What's Next?

Hi peaches and cream,

I'm obviously very sorry for what's happened.  It is a rare but traumatizing complication.

In general, you need to first let the area heal, and after that you can consider any of a range of reconstructive techniques.  Healing the wound is done with a combination of dressings, wound care and, rarely, the use of some devices.  You should, of course, remain under the care of your plastic surgeon throughout this entire process but particularly as the wound is healing.  This will be the time that you need the most support, from every standpoint.

Once the region is healed there will be a choice of things that can be done.  These include nipple and areolar grafts, tattooing, etc.  You should again work closely with your surgeon on this.  If you have any questions, at any point, you should not hesitate to obtain other opinions before you proceed.

Again, I'm sorry for your course thus far; hopefully, you will wind up with a result you'll be happy with.

Dr. E


Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Areola and nipple have died

this can happen, fortunately not commonly. you are doing the right thing in seeing you doctor. he/she will guide through this complication. i am in favor of removing "black, dry, leathery " tissue but it should be conservative to avoid removing tissue that might have survived. you may finf the loss to be minimal and not need any further intervention. good luck and hang in there. also it is OK to get a second opinion.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

Loss of nipple and areola after breast reduction

This is a rare but unfortunate complication of breast reduction/uplift. The dead nipple/areolas have to be removed. Usually the tissues will be allowed to heal and settle then for a few months before reconstructing them. Briefly, the nipples are created by folding skin flaps in a number of ways. The areola is reconstructed by tattooing or with skin grafts.

Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon
4.8 out of 5 stars 32 reviews

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.