Nipple pain and scar tissue pulling after 8 months. Will it ever improve?

Question

I explanted 3 years ago but had continuing discomfort in my left breast. An MRI showed a seroma and scar tethering. I had surgery to remove these. The surgery has left me in so much pain, I sought a second opinion. Further surgery was not recommended. My nipple was initially numb after the surgery but now I can hardly touch it. I just want to know if my nipple soreness and pain will ever improve as it has been 8 months since my last surgery and it is really getting me down.

George Bitar, MD · Answer

Thanks you for the question.  Sorry to hear about your situation.  The good news is that the numbness is gone and the sensation is returning.  For nErve paiN some patienTs find lyrics or neuron tin helpful.  Discuss with your surgeon.

Lavinia K. Chong, MD · Answer

Sorry to hear of your predicament.  I am going to make some assumptions, based on your history, which may or may not be accurate. 1. Did you explantation surgery include capsulectomy (complete removal of surround scar tissue)? 2. Were drains used? 3. How soon after surgery did the seroma (fluid collection) manifest? 4. Were both surgeries performed via the areolar approach?Seromas are a collection of fluid under the breast skin flap and are problematic because the protein rich fluid can predispose to infection and more scarring.  Although many explant patients ask whether the areolar incision can be used, I usually recommend the inframammary fold for the following reasons: 1. avoidance of a "depressed" or tethered "fishmouth" scar; 2. less chance of sensory disruption of the nipple-areolar complex (hypersensitivity and/or anesthesia); 3. potentially less visible, assuming the breast flap drapes over it. Ask your PS consultant whether (s)/he recommends gentle massage of the nipple to assist in desensitization and to avoid the possibility of CRPS (complex regional pain syndrome).  Restoring "normalcy" to your nipple and improving the scar appearance should be your first priorities, which I think are quite feasible.  Good luck!

Nipple pain and scar tissue pulling after 8 months. Will it ever improve?

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