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.

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.

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.