Black/purple spots on scar line 12 weeks post breast reduction. Is this common? Could the nipple be dying?(photos)

Black or purple spots along the scar line 12 weeks post breast reduction surgery can be concerning, and it's important to have them evaluated promptly by your plastic surgeon. While it's not possible to diagnose the specific cause without a thorough examination, there are a few potential reasons for these spots:
1. Bruising: It's not uncommon to have residual bruising along the scar line for several weeks after surgery. However, bruising typically resolves over time as the body heals. If the spots are indeed bruises, they should gradually fade and disappear.
2. Hematoma: In some cases, blood collections (hematomas) can occur beneath the skin after surgery, leading to areas of discoloration. Hematomas may require drainage if they are large or causing discomfort.
3. Necrosis: Necrosis refers to the death of tissue, and if the blood supply to the nipple or surrounding tissue is compromised, it can lead to tissue necrosis. This can present as darkening or blackening of the skin, and it's a serious complication that requires immediate medical attention.
4. Infection: Infections can also cause changes in skin color, including black or purple spots. Signs of infection may include increased redness, warmth, swelling, pain, or discharge from the incision site.
Given the potential seriousness of these symptoms, it's crucial to contact your plastic surgeon or seek medical attention promptly for further evaluation and management. Your plastic surgeon can assess the condition of your scar, nipple, and surrounding tissue to determine the cause of the spots and recommend appropriate treatment. Depending on the underlying cause, treatment options may include observation, wound care, antibiotics (if infection is present), drainage of fluid collections, or surgical intervention if necessary.
While it's natural to feel concerned about changes in your scar or nipple appearance after breast reduction surgery, seeking prompt medical attention can help address any potential complications and ensure optimal healing outcomes.

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Dear Ledz3p,
I understand your concern. Based on your photos, this is probably caused by sutures under the skin. However, without a proper assessment it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery