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

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?

Doctor Answers 3

February 7th, 2015

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

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Appears as necrotic graft. You need immediate medical attention to treat this complication. Sorry for the issue. 
Darryl J. Blinski, MD
February 6th, 2015

Nipple graft post mastectomy

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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. 
Allen Gabriel, MD, FACS
February 5th, 2015

Be patient

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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.
Vincent A. Naman, MD

Vincent A. Naman, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 37 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.