Is this nipple necrosis? Its two weeks old. (photo)

Question

I had gynecomastia surgery two weeks ago. I wear the compression garments at all times only taking off to wash/change garments. In between i apply neosporin and massage gently and redress in garments. when taking off the under garments the dark scabbing part of my nipples usually stick and pull off, i thought nothing of it, they never bothered me but today i noticed a discoloration that looks like fat in the areola section of my right nipple. Is this necrosis, should i apply sterile dressings?

Jeffrey D. Wagner, MD · Answer

From your pictures, it appears you have partial necrosis of the nipple papule.  In most partial loss cases, this is likely to heal with conservative wound cares.  I usually recommend topical antibiotic ointment and avoidance of pressure and smoking, both of which can worsen the injury.  Get back in to see your plastic surgeon soon.

Matthew A. DelMauro, MD, FACS · Answer

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) Based on your photos, there appears to be some injury to the nipples. The severity of the injury is unclear. (A physical exam is necessary to determine this.) You should follow up closely with your plastic surgeon. Best of luck!
Matthew A. DelMauro, M.D.

Darryl J. Blinski, MD · Answer

You need immediate evaluation of partial nipple necrosis by either your operative surgeon or seek a boarded PS to render follow up care.

Johnson C. Lee, MD · Answer

Thank you for your photo. It appears that you do have an wound/injury to the nipple areola complex but not the entire area. It is best to keep the area clean until you can contact or be evaluated by your surgeon ASAP for a closer examination. Occasionally wounds may open around surgical sites - the majority of these will heal on their own with home care. Hope this helps!
Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Is this nipple necrosis? Its two weeks old. (photo)

Answers (4)