What Cause's Nipple Death?

Nipple death can occur after several types of  breast surgery namely: Breast Lift, Breast Reduction, Subcutaneous Mastectomy, Lumpectomies, and vary rarely even from a Breast Augmentation. The reason is usually  because of compromise of the blood supply or infection. This is a very unusual event for a Plastic Surgeon that is Board Certified by the American Board of Plastic Surgery.

The Nipples and Areola,  the nipple surrounding pigmented skin, rely on blood flow both arterial and venous)  from surrounding tissues.  During breast surgery that prevents blood flow from too tight of a closure around the nipple/areaola or  separates this structure from its arterial or venous blood flow it may not  survive..Smokers (nicotine constricts the micro-vasculature to the skin, nipple and areola) and patients prone to infection have  dramatically higher rates of this complication. 

 

Rarely, after breast surgery, the nipple, areola, or any other areas could have a lack of blood flow.  If the lack of blood flow is significant, the tissue will die.  Eventually the tissue will slough off or be debrided, leaving an open wound.  Then the wound will either heal in or be surgically closed.Some factors that increase the risk of poor blood flow are smoking, nicotine, hypertension, blood clotting disorders, other medical conditions, infection, excessive swelling, and tight garments.  Factors related to the surgery such as re-do procedures and more extensive procedures also increase the risk of healing problems.Fortunately, the risk of nipple death is rare in most cases when the patient has addressed their risk factors and the surgeon is experienced with the procedure.                          

Nipple death or necrosis can occur as a result of a breast lift or tummy tuck.  Necrosis is the medical term for death of tissue. The most common cause of tissue death following surgery is lack of blood supply. All of our bodily tissues require sufficient blood flow to keep it alive. During the course of surgery blood flow to the tissues involved is decreased to some degree. If the blood supply is decreased sufficiently the tissue at the end of the blood supply may die.  Cigarette smoking is known to decrease the blood supply in the skin and fat layer. If a wound is showing signs of necrosis it is important to stop smoking immediately.   It is very important to keep in close contact with your surgeon to help monitor and support the healing process.

The most common cause of nipple necrosis (death) after any surgery would be poor blood flow. This would be an unusual complication, but smoking, hypertension and obesity will increase your risk for this complication.

Nipples rely on blood flow from surrounding tissues.  During breast surgery that separates the nipple from some of those sources of blood flow, the nipple may not maintain enough healthy blood flow to survive.  This is a very rare complication of breast lift and breast augmentation, as most of the tissue underneath the nipple is left intact.  Smoking dramatically increases the rate of this complication, as nicotine constricts the important small blood vessels extending to the nipple.

The short answer to a very broad topic is that inadequate blood flow will cause nipple necrosis. There are many reasons for poor blood flow depending on the type of surgery, patient health and surgical design. A big cause is smoking!