I Had my Breast Reduction 5 Days Back, Nipple Partiall Black, Could This Be Necrosis?

Question

On the 2nd day post op, the surgeon came to have a look at my breasts and did not observe anything unusual. Yesterday (4th day post op), I went to get my bandage changed and she told me that the nipple on my right side has turned partially black. Could this be a nipple necrosis? Is there any way to cure it? She told me that she would inject me with some homoepaethic meds? Have you ever heard of this? She did not mention necrosis yesterday but I remember her having it mentioned once. Thanks!

Randy Proffitt, MD · Answer

Blistering of the skin, as well as dark color turning to black are indicators of poor blood flow and could lead to necrosis. There are few cures and the earlier the better. Tension on the tissue can contribute so releasing tension can help. Hyperbaric oxygen can help if instituted early in some cases. Most medicines by mouth or topically are only placebos. Talk to your surgeon. The good news is most are limited to small areas and heal better than you might think.

Tom J. Pousti, MD · Answer

Thank you for the question.

	It is not possible to give you good advice without direct examination or pictures.

	Partial or complete loss of nipple/areola blood supply is a potential complication of breast reduction surgery. Your plastic surgeon will be in the best position to diagnose and treat this issue if it is present.

	Best wishes.

Robert L. Kraft, MD, FACS · Answer

The black coloration is of concern as your nipples could be necrotic.  You should definitely return to your surgeon.  It is possible to perform debridement procedures in an attempt to save the nipples.  I have never, in my years of practice, prescribed a homeopathic remedy for a postoperative patient and heard of injection of such substances.  If you have concerns, you may want to obtain a consultation from a board certified plastic surgeon.  Nipple necrosis is an unfortunate but recognized complication of breast reduction surgery but it can be managed in many patients to avoid complete loss of the nippe.  Best of luck in your recovery.

Darryl J. Blinski, MD · Answer

Sounds very serious and maybe TOO late to save your N?A complex. You did not post a photo. And time in these situations is of the essence. I fear after 3 days your chance on saving the black areas is gone, sorry. Seek in person discussions for care and plans for correction or a second opinion.

Carlin Vickery, MD (retired) · Answer

Nipple necrosis does present as a darkening of the nipple areolar area. If you have an area that is black it likely represents a significant vascular injury and you may lose some of the overlying skin. The black area will become hard like a scab and over several weeks it will separate from the underlying tissue. If the area is only several millimeters wide, then the edges will likely heal over time although you may have some loss of pigment.

Ronald H. Stefani Jr, MD (retired) · Answer

Color change to the nipple can be worrisome and you should be seen regularly 2-3x/week by your surgeon for the next couple of weeks. A trained eye will diagnose necrosis and stay on top the treatment. I fit is a necrosis complication careful management can help lessen the adverse end result. I hope this info helps.

Alan M. Engler, MD, FACS (retired) · Answer

Hi Vmen,

	You need to be seen in person by a plastic surgeon.

	Necrosis of tissues - whether nipple, areola, flap or any other - is a justifiably feared complication of surgery.  When noticed early on (ie withing a day or so) various methods of treatment may provide relief and abatement of the problem.  The longer it goes unattended the less the likelihood that any of the process is reversible.

	If, in fact, it turns into more florid tissue necrosis you will need to undergo wound care until the wound is healed and then, if necessary, subsequent procedures or tattooing for the best aesthetic result.  Hopefully none of this will occur, but you may have to wait a bit to find out.  In the meantime, you should be under the care of a competent plastic surgeon.

	I hope that this helps, and good luck,

	Dr. E

Christine Sullivan, MD (retired) · Answer

This is concerning. Contact your plastic surgeon and schedule an examination. Upon examination, your board certified plastic surgeon will be able to explain what is happening and why. Best of luck.

I Had my Breast Reduction 5 Days Back, Nipple Partiall Black, Could This Be Necrosis?

Answers (8)

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