Skin of areola peeling off after breast reduction?

Question

I had a breast reduction about 3 weeks ago. This was a free nipple graft and everything. I had drains, "rosebuds", and stitches/staples removed with no issues. However, no the skin of the areola, which is a burnt, brownish color is coming lose & coming off. Sometimes it bleeds. Doc says skin is trying to take but a whole part of areola skin has come off. I've done everything right. Is this skin supposed to come off? I can't even feel my nipples. Is this the skin that's supposed to be attaching?

James D. Frost, MD · Answer

AngelicaOnly your surgeon can accurately answer your question because he/she knows what was done and has the advantage of examining you. It is relatively uncommon to place the nipple as a free graft.  There are however circumstances, such as gigantic breasts, where that is the best choice.  When the nipple is completly removed and then replaced, it would be expected that there would be no sensation.  The nerves have all been disconnected.  You should not expect the nipple to ever have sensation you would consider normal again.It is more difficult to answer your question about the skin peeling.  At 3 weeks postop, I would expect to see some thin sheets of skin coming off as you might see when a sun burn peels.  This does not mean the skin graft has failed, only that the top layers of skin are shedding.  It is also common to have a little bleeding.  If you have large "raw" areas, that may signal more concern but take the advice of your surgeon on how to care for these areas. Talk openly with your surgeon.  He/she has presumably done this before and can guide you through.  Good luck to you.  Try to be patient.  Healing takes time.

David Finkle, MD · Answer

Women with extremly large, very droopy or have poor circulation to their breasts can still undergo breast reduction procedures.  However, the technique used is different, the nipple/areola (N/A) is removed from the breast as a skin graft at the start of the procedure and then placed back on the breast after it has been surgically reduced.Because the nipple has been completely removed from the breast, all feeling, sensation, ability to breast feed and blood supply is severed.  The nipple will be permanently numb and no breast feeding will ever occur again.  When new blood vessels grow into the skin grafted N/A the outer layer of skin falls off and new skin grows from the undersurface.  It is like a snake shedding it's outer coat of skin as it grows.  This is a normal phenomenon, I recommend placing a thick coat of antibiotic ointment over the N/A and cover with a non sticky dressing.  Change this twice/day and wash gently with soap and water.Good Luck!

Skin of areola peeling off after breast reduction?

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