Mastectomy- Nipple Graft slightly separated with thick white substance. Is this my graft rejecting? (photos)

Question

I had a subcutaneous mastectomy with nipple grafts 9 days ago. The edge of one of the nipples has this this white stuff on it. When I let water run over it in the shower, the water ran slightly under the edge of the nipple scab. Is this my graft rejecting? Or does it just need more time to heal from the bottom up?

Allen Gabriel, MD, FACS · Answer

Thanks for your pic and questions.   From the picture it appears that you are healing and if a full thickness graft was done then majority of the areola is vaible and the nipple will take longer to vascularize.  You may lose some height which is very normal and some pigmentation.  You can always see a medical tattoo artist in 6 months  to improve the transition and coloring.  Make sure you are healthy and eat a well balanced diet and stay away from smokers.  Best of luck.

Vincent A. Naman, MD · Answer

Thank you for your question and photo. Nipple grafts will often undergo a certain degree of slough of the top layers of skin.  While I cannot be certain from the photo, it seems likely that you are losing the most superficial layer of skin from the nipple, but may still have sufficient deep layers that have taken and will provide a satisfactory final result.  At nine days post op, there are some basic measures to optimize your results: No smoking or second hand smoke, Gentle washing and antibiotic ointment.  Be aware that thinks may look a bit worse before they look better.  All the best.

Darryl J. Blinski, MD · Answer

Appears as necrotic graft. You need immediate medical attention to treat this complication. Sorry for the issue.

Mastectomy- Nipple Graft slightly separated with thick white substance. Is this my graft rejecting? (photos)

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Mastectomy- Nipple Graft slightly separated with thick white substance. Is this my graft rejecting? (photos)

Answers (3)

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Everything you need to know about Mastectomy

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