Please help me! Is this necrosis? Will it heal? (photo)

Question

My doctor says this is a form of necrosis but should heal over many months... Because there is still viable tissue but it all seems to be getting darker.. I am Terrified.. Is this tru or is it going to take over my whole nipple???

Andrew P. Trussler, MD · Answer

This looks like complete nipple ischemia, likely from lack of venous outflow or venous congestion. The entire nipple may slough however recovery depends on viability of underlying tissue. Close follow-up is needed with antibiotic ointment for hydration.

Manish C. Champaneria, MD · Answer

Thank you for your question.The darkened appearance of the tissue appears to be some form of necrosis, though a physical examination is the best way to diagnose this. With this scenario, watchful waiting will help determine what tissue lives and what does not. I would frequently visit your plastic surgeon and trust their advice. Good luck!Regards,Manish C. Champaneria, MD

Khashayar Mohebali, MD, FACS · Answer

Based on the pictures there appears to be some level of necrosis but its only part of your nipple and the level or degree is hard to tell without an exam.  Continue to follow up with your surgeon for it be evaluated and followed until it is healed.

Jourdan Gottlieb, MD · Answer

It does look as though there is some tissue loss, particularly at the 3 to 5 o'clock position. About the nipple itself I can't tell based on the photos. There are some things that can be done to minimize the damage to skin that is injured but not necrotic, such as the use of nitroglycerine paste.  If this is the chosen treatment starting right away will increase the chance of it working.  Even though it may be late, your surgeon can call in a prescription.All the best.

Matthew Kaufman, MD · Answer

I would agree that this is necrosis.  To what extent I can't say without an examination.  You should follow the guidance of your Plastic Surgeon and consult with him/her for any concerns.  With necrosis it's a watch and wait scenario.  Good Luck

James E. Leake, MD (retired) · Answer

your photos do demonstrate some degree of blood vessel distress. the areas that are pink or purple should continue to improve slowly. the black areas may not survive. ask your plastic surgeon for nitro bid paste to help encourage better blood flow to this area, apply it twice a day (it may give you a headache). all you need is a thin coat. do not smoke or use nicotine products. do not wear a tight bra, do not lay on your chest. good luck. just be patient.

Please help me! Is this necrosis? Will it heal? (photo)

Answers (6)

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