Expected Outcome of Nipple/areola? (photo)

fng breast reduction, post op day 18. i have had issues with right nipple since I had the dressings taken off at week 1. I was originally not supposed to see him again until 1 month but have gone in several times since bc of concerns. I'm just wondering if this is healing like it is supposed to, what the expected outcome is, etc. also, I have absolutely no nipple projection. He said it was du to swelling and I would get it back in a couple months, is this true? I want to trust but am discouraged

Doctor Answers 10

Partial Nipple Areola Necrosis after Breast Reduction

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     The pictures help, but a physical exam would be more accurate.  Your plastic surgeon can examine you, and that makes his assessment more useful.  Just from the pictures, it appears as though most of the areola may survive.  At this point, there is nothing to do but keep the area clean and wait.  Do not worry yourself in the meantime.  You may end up with a very good result.

Partial loss of the nipple and areola after breast reduction often yields a satisfactory result without further surgery

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The photograph will demonstrates the areola suffering after a breast reduction. Some of the areola might be lost. Surprisingly, as the area heals the areola and often times look fairly normal. Time will tell

Nipple-areola necrosis after breast reduction needs treatment.

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Maybe you should get another opinion.  You have some necrosis (loss of tissue), and you will probably lose nipple projection.  I recommend Silvadene cream for now.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Healing of Partial Nipple-Areolar Necrosis

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The resolution of your partial nipple-areolar necrosis is a process and one that will take months until it is fully healed. The black eschar (scab) must be allowed to heal underneath and then allowed to come off to reveal nearly healed skin underneath. The healed areolar area will likely have loss of some pigment and it is not yet clear what effect this will have on the nipple shape and projection. The good news is that it will eventually look much better than you envision right now. The bad news is that it will take 2 to 3 months to get there and may take a small revisional procedure for an optimal outcome. But there is nothing to do for now but be patient and follow your plastic surgeon's wouond care instructions.

Partial nipple/areolar loss after breast reduction

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Dear Breezy130

Thank you for your photographs and I am sorry for the complications you have had so far with your breast reduction.  Fortunately, it appears that it is healing well, and that you have mostly a superficial loss of tissue, and that in time most of this will heal.  The final scarring that could occur with this will not be known for some time, and could require a revision to improve the shape of the nipple and/or areola.  I would keep in contact with your plastic surgeon.

Good luck

Robert Kratschmer, MD

Nipple/Areolar Skin Loss Should Improve Significantly

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Thank you for your question and photos.  You do have evidence of partial areolar and nipple skin loss. This is common in smokers and diabetics and uncommon in most BA patients.  If you have been exposed to first hand or second hand smoke I would recommend avoiding further exposure. The good news is that despite this complicaiton, it should heal very well with a good result.  This will take some time and patience on your part. I would recommend discussing your concerns further with your surgeon. Best wishes.

Nipple loss

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It looks like you may have partial nipple and areola loss.  At this point you should follow with your surgeon very closely.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Nipples after breast reduction.

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The pictures you have posted demonstrate what looks like partial necrosis of the nipple.  The good news is there is obviously a blood supply of the deeper tissues.  

This complication arises when the blood supply to the nipple is compromised with breast reduction surgery.

A typical outcome of this known complication after breast reduction may include loss of nipple projection, discoloration of the nipple/areola, firmness of the underlying breast tissue and problems with areola shape.

If you are a smoker, I would recommend stopping.  Your PS will have experience with this type of problem to help you through it.  

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 189 reviews

Nipple and areola healing problems following a breast reduction

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It does appear that you have had some partial tissue necrosis due to compromise of blood supply.  Fortunately most of the structural components of the nipple and areola are intact and should likely heal over time.  The best thing that you can do is wait it out and follow your plastic surgeon's advice.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Nipple/areola changes

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It looks like you have developed partial nipple areola necrosis after bresst reduction.  This is  unfortunately  too common a complication after breast reduction.  This usually heals much better than originally expected.  You would need to wait for several months and may require some revision surgery to improve the aesthetics.

Good luck

Ary Krau, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 357 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.