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There are two problems related to blood flow that can happen after breast lift or reduction. Lack of blood flow TO the nipple and areola complex and problems with blood flow AWAY from it. Problems with blood flow TO the nipple and areola can be treated with creams that dilate the blood vessels or with hyperbaric oxygen. Problems with blood flow AWAY from the nipple and areola are treated with leeches (yes, leeches) or with removal of some of the sutures to reduce the tension on the closure. Based on on your photo, if there are continued problems with blood flow, it looks like it's very superficial. This means you will likely formed little scabs on the nipple and areola, but thenhave them heal without any further problems, except for a temporary color change to the skin. Your surgeon seems to be on top of the problem and I would trust his or her advice regarding this issue.
Thank you for submitting your question. Mild congestion can be treated with topical cream. If there is true compromise then releasing the sutures would be helpful to decrease the tension. Hyperbaric can also be helpful. Continue close follow up with your Plastic Surgeon. Best Wishes.
It would be helpful to see the pre-operative photos to determine the level of elevation of the nipple/areola. Compromised blood flow to the nipple/areola can occur with lifts and reductions. In addition to hyperbaric treatment there are local vasodilators that can assist in the attempt to salvage the tissue. Stay in close contact with your Board Certified PS.
Really not certain your suffering from venous congestion although it does look like the areola is not pleased with the operation. You seem to have gotten an excellent result in my guess is that the areola will look perfectly normal when healing is complete.
Kudos to you on choosing the right plastic surgeon. It appears your surgeon did an excellent lift/augmentation, and then when he or she realized there was some compromise to the nipple areolar complexes, he or she recommended hyperbaric oxygen (brilliant!). At this point, it appears that whatever compromise you had originally, it has now become quite minor and superficial. If you were my patient, at this point, I would recommend one more hyperbaric treatment just for cheap insurance, and then the use of Silver Sulfadiazine on the discolored areas of your areola to keep down the bacterial count and moisturize your areola to allow natural wound healing. From what I can see, all these darkened areas on the areola will heal below the epithelium. There will be a minor slough and some minor discoloration which should correct itself with time.
After 3 days of possible venous congestion/compromise leeches are to late to use as is incision release or use of nitro paste/calcium channel blockers. These all need immediate use < 24 hrs from surgery. Now try hyperbaric O2 therapy or healing time . Sorry for the post op issue.
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