Dark Nipple After Gynecomastia and Areola Reduction Surgery?

Question

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

Jed H. Horowitz, MD, FACS · Answer

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.

Otto Joseph Placik, MD · Answer

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

Babak Dadvand, MD · Answer

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. Sincerely,Dr. Dadvand

Robert L. Kraft, MD, FACS · Answer

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.

Mordcai Blau, MD · Answer

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

Dark Nipple After Gynecomastia and Areola Reduction Surgery?

Answers (5)