FTM Nipple graft not taking

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 subcision or excision. Best, Dr. KaramanoukianRealself100 Surgeon

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.

Im sorry to hear your frustrations.  This is something that unfortunately happens from time to time. A successful nipple graft is not a 100% successful operation, and to some degree its not surgeon dependent.  You could be the most experienced surgeon in the world, but there is still a chance your body just doesn't grow the blood vessels into the tissue quickly enough to maintain it.  That being said, your surgeon will likely allow this to declare itself and then either let the scab fall off on its own, or perform some minor debridement in the office.  I would then let everything heal and scar in and see how it looks.  You may be surprised and just stick with that result.  If not, there are options for nipple reconstruction using surgical techniques as well as tattoos.  Good luck"The above answer has been given without seeing this patient and cannot be substituted for actual in-person examination and medical advice; it is only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Nipple grafts have to "take" onto the location that they are placed. This means that new tiny blood vessels must begin to grow into the graft within 4 days, or else the nipple will die. Several factors contribute to high success rates , such as graft compression, graft immobilization, prevention of bleeding, removal of wxposure to nicotine, etc. Neverthe less, some grafts do not take partially or fully. It happens to all surgeons, no matter how good the technique. 
Fortunately, after the graft loss has healed, a re-creation of the nipple is available.

Hello. Thank you for your question. Nipple grafts sometimes have difficulty healing. It is important you discuss with your doctor the management of this delayed healing as each surgeon will have his/her own approach. I would not fret too much. Once the nipples are healed there are fantastic tattoo artists that can provide both pigment and dimensionality to the nipple. 

Hi Andy,
Nipple grafts commonly have this problem, and is one of the reasons i try to use a pedicled technique when possible. Skin grafting is the basic technique used for nipple grafts- in this the nipple is completely removed, thinned of excess tissue and inset to a new position. It loses its original blood supply a new one must grow in. We try to help this by making sure that all of the surface of the graft is in contact with the the raw area at its new site and using a compression dressing to obliterate any spaces. The thicker the graft, the further the new blood vessels have to grow, so thinner grafts will generally heal more quickly. Unfortunately, nipple-areola grafts are thicker (even after thinning) and the central nubbin of the nipple often keeps its domed shape making it hard to flatten out.  I always explain this process to patients so they understand why there is a delay in healing. It will heal, but it takes time and you should see your surgeon for regular dressings. If there is redness a course of antibiotics may be indicated. 

Hi Andy,Thanks for the post and photos. Agreed you are having healing issues with your nipple grafts. This will require local wound care with ointments and local debridement by your plastic surgeon. I recommend you follow up with your surgeon for management of this. I do see the redness you are referring to. There are several signs of infection, with redness only being one of them. Other signs are increased warmth in the area, increased swelling and increased pain. Again follow up with your surgeon to evaluate this as well. Sincerely,Dr. Dadvand