Bilateral mastectomy for gynecomastia; I have complete nipple necrosis on the right breast and a small divot. Options? (Photos)

The nipple has complete necrosis and is now a scar. I know that I will never have a nipple again and I am at peace with that, however I am in moderate pain. It is very sensitive and aches/burns throughout the day. Now for the divot, can there be a lipo injection or get graft in the area so at least I'm more aesthetic?

Doctor Answers 3

How to correct male nipple death (necrosis)?

Hi Mhermick,

Thanks for your question and photos. I am extremely sorry that you are going through this. This outcome is extremely rare especially in experienced hands. Based on your photos is does not appear like a total mastectomy was done as there still appears to be breast tissue around the area of nipple necrosis. To fix the issue, what I have done for other patients that have presented like you after they were treated by other surgeons is to move the skin around and shift some fat or transfer some fat from the surrounding areas. On the tissue is closed and has a stable base, nipple reconstruction and tattooing is possible to improve the overall appearance.

The pain that you are having could be from the scar tissue trapping nerves or a neuroma or just the slow healing process. I recommend being seen by a board certified plastic surgeon with lots of male breast surgery experience. Good Luck!

All the best,

Carlos Mata MD, MBA, FACS

Board Certified Plastic Surgeon

Gynecomastia complications

This is unfortunate but it does happen. I would suggest that you allow things to settle down and let the healing process proceed. Local wound care on the open area will eventually result in its closure. I would start using a Roller device over the chest to help soften things over the coming months as well as hand massage to any areas that are firm. 

Then I would go back and treat the chest so the tissue layer is even and symmetrical which will improve the appearance significantly. A new nipple-areola complex can be "built" by a good surgeon but often this isn't needed as the scar "appears" like a nipple-areola and patients are often comfortable with the result without the need for additional procedures and risk.


Hello and thank you for your question. I am sorry to hear about your surgical course thus far. To correct the depression it may be possible to break up the scar tissue underneath and do some lipofilling to improve the contour. For the nipple that has died I would consider a tattoo in order to match the color of your native nipple. 

Best Wishes 

Theodore Nyame, MD
Charlotte Physician
5.0 out of 5 stars 28 reviews

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