Dark Nipple After Gynecomastia and Areola Reduction Surgery?

I had gynecomastia and an areola reduction surgery 5 days ago. I feel fine with little pain and discomfort, but one of my nipples (right side) is much, much darker than the other. Both of them are seemingly numb, but the ride nipple is almost purple.

What is the cause of this? Loss of blood circulation or due to the sutures? Is this a "dead nipple" and will I lose my nipple or need reconstruction? I just want to know if this is normal or something that I should be concerned about. Very disturbing and worried.

Updated Feb. 24, 2010:

As requested, here is a picture of the nipple I mentioned in my previous question. I did see my PS today and he said that it "should be just fine", and that it looked like it was "vascular (or venous) congestion" in the nipple. Is there anything I can do to uncongest this or get color to return to normal as soon as possible (like my left nipple). Any help, advice, or expertise is much appreciated. On the phone the other day he did say that it looked like I had good blood flow after the surgery/sutures

Doctor Answers 10

What to Expect Post Gynecomastia Surgery

Following #Gynecomastia #surgery, your incisions 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.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Nipple Discoloration After Gynecomastia Surgery

Hi 60642,

Thank you for the post and the photo. There is a natural darkening of the areola and nipple after gynecomastia surgery. Take for example a balloon that you color with a black marker. When the balloon is inflated it appears lighter than when it is deflated. However, in your case the discrepancy between the areolas can also be due to circulation disturbance. I would keep in close communication with you plastic surgeon.


Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 44 reviews

Dusky areolae after gynecomastia surgery

The duskiness of the areola can be associated with bruising or with loss of vascularity after the surgery. There is always a concern about necrosis of the nipple based on restricted blood supply so it is important for you to followup with your plastic surgeon on a regular basis. In most cases, as the swelling reduces, the coloration changes.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Darking of the areola is not uncommon post surgery

 Venus congestion can be present in same cases, and pigmentation of the areola is pretty common after gynecomastia surgery.The darkening is as a result of the shrinking arelas and therefore the melanin is more concentrated.Both phenomenon do not damage the areola and the congestion is most often temporary.No treatment is required

Mordcai Blau, MD
New York Plastic Surgeon
4.6 out of 5 stars 74 reviews

Purple areolae and nipples after gynecomastia (male breast) reduction

It is not uncommon for the areola to look slightly darker after surgery. Capillary refill should be assesed to insure adequate vascularity.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

See your surgeon for changes in nipple color after gynecomastia surgery


Your surgeon will deftly want to hear about any change in your nipple color after surgery. This may be caused due to excess swelling or bruising or maybe the results of your nipple not getting enough of the blood supply. Either way your surgeon will be very concerned and will want to assess you.

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 101 reviews

Poor blood supply to nipples after gynecomastia surgery.


I recommend applying Silvadene cream to nipples three times a day. This is an antibiotic cream used on burns that is very effective. You have not enough blood flow to your nipples after male breast reduction, but they should heal as long as infection is prevented. Skin with bad blood supply is very prone to infection.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Funny nipple after gynecomastia and areola reduction

It looks like there is some vascular congestion, and also blisters appear to be present.  If your doctor diagnoses the cause to be venous, then some topical nitroglycerine may help. I think it will likely be okay, however.

Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 101 reviews


The color of the nipple areola may get darker during the healing process. from the picture you posted the nipple areola seems normal with good circulation. If you are concerned then you should call your doctor, nothing better than a physical exam to put your mind at ease.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Dark nipple after gynecomastia Surgery

Without a photograph it is impossible to tell you exactly what is going on. The fact there is a large color discrepancy between the color of your nipples is indeed worrisome. "Almost purple" is not a color we surgeons like to see when something is supposed to be pink and warm. It indeed MAY be a case of poor blood supply. Rather than worry about it, you MUST be seen by your surgeon immediately. Personally, I would stop wearing any compression vests you may be wearing and go see your surgeon

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.