Is/are my nipple graft(s) failing, or is this normal healing? (photos)

Question

11 days post op from a double incision mastectomy with free nipple grafts (I'm FtM). Bolster dressing taken off 5 days post op, and have been using ointment with bacitracin and keeping gauze over the grafts per doctor's orders since then. Scheduled to get the stitches around the graft out mid next week. I am concerned about both of my grafts. Both nipples are very dark brown, much darker than they were naturally pre-op. The left side, a chunk of the areola is a fairly dark brown as well.

Rukmini S. Rednam, MD, FACS · Answer

Hi Mich,From your photos and the stage of healing your currently are in you appear to be healing as expected.  There are often color changes with darkening in the immediate post op time period and over time the grafts will peel and the newly healed tissue is generally lighter and smoother. It's all part of the healing process with this type of surgery.  In some cases if the pigmentation does not return well, medical tattooing can be used to improve the appearance.Best of Luck with your healing!Dr. Rednam

Jed H. Horowitz, MD, FACS · Answer

It is still very soon into your #healing and your incisions and #nipples will go through a maturation #process. For the first few months they will be red and possibly raised and/or firm. As the scar matures, after 6-12 months, it becomes soft, pale, flat, and much less noticeable. You may experience numbness, tingling, burning, “crawling”, or other peculiar sensations around the surgical area. This is a result of the #healing of tiny fibers which are trapped in the incision site. These symptoms will disappear. Some people are prone to keloids, which is an abnormal scar that becomes prominent. If you or a blood relative has a tendency to keloid formation, please inform the doctor.Bruising and #swelling are normal and usually increase slightly after the removal of any tape or foam. The bruising will decrease over 3-4 weeks, but may last as long as 6 weeks. The majority of the swelling will be gone within the first 3-4 weeks. However, it may take 6-9 weeks to disappear completely. Also, as you heal, the area may feel “lumpy” and irregular. This, too, decreases with time, and massaging these areas will help soften the scar tissue. The #compression garment helps reduce the swelling, and the longer it is worn, the more quickly you will #heal. It can also assist in the retraction of the skin. If you have any concerns about #healing, its best to ask questions of your surgeon or their nursing staff.

Douglas M. Senderoff, MD, FACS · Answer

This seems like normal discoloration after top surgery.  Be sure to visit your surgeon for a post operative exam to make sure everything is healing according to plan.

Sheldon Lincenberg, MD · Answer

The nipple grafts will go through several phases of healing. The nipples will become dark and form a scab, which will fall off in 2-3 weeks. The areolae will peel the top layer of skin off, and then heal in another week. If you are dark-skinned, the areola will lose its pigmentation, which will slowly return in 6-12 weeks. You may need pigment replacement if it returns incompletely.

I hope this helps.

Is/are my nipple graft(s) failing, or is this normal healing? (photos)

Answers (4)

Answer: Nipple grafts

Answer: Nipple grafts

Recommended reading

Everything you need to know about Masculinizing Top Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

Is/are my nipple graft(s) failing, or is this normal healing? (photos)

Answers (4)

Answer: Nipple grafts

Answer: Nipple grafts

Browse related questions

Recommended reading

Everything you need to know about Masculinizing Top Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.