What's Going on with my Nipple? (photo)

Question

A month ago I had a male breast reduction surgery I had a problem with blood flow to the nipples but my surgeon said that the blood vessels will be rehabilitated and the black part come off in a few weeks But nipples show signs of necrosis Is it superficial or deep? the big black piece looks like it's going to fall

Michael Constantin Gartner, DO · Answer

It does look like you have some tissue loss on the areola unfortunately, and it may be deep. It is a rare risk of surgery.

Vincent N. Zubowicz, MD · Answer

The photo demonstrates partial loss of viability of the areola. There is a good chance that is the eschar separates in the areas given the opportunity to heal it might look fine.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Unfortunately, you have full-thickness (deep) tissue loss.  These area will peel off eventually when the healing is complete beneath.  This healing will result in some contour issues with the nipple and areola.

	Dr. ES

Kenneth Hughes, MD · Answer

Areolar Necrosis can occur, and yours appears to be at least superficial.  If it is superficial, the areola should do very well with time.  Kenneth Hughes, MD Los Angeles, CA

Brian K. Reedy, MD · Answer

Unfortunately, you suffer some loss to your nipple. This is a very rare but recognized complication. It can be more common in smokers. Let it heal and probably nothing else will need to be done after time and massage. However, you may need revision to the nipple but I would wait 6-12 months. Good Luck.

Larry S. Nichter, MD, MS, FACS · Answer

You have lost some of your nipple due to necrosis which is a fancy term for "tissue death". It appears that there is no infection so most likely it was due to too little blood flow. This is a complication that can happen but fortunately not commonly. It is seem more often in smokers or nicotine users. I would wait several months to a year to determine what if any reconstruction you may need.

Paul Wigoda, MD · Answer

You have necrosis of part of your nipples. This occurs when the tissue does not have enough blood flow. At this point, you need to have the black tissue removed (debrided) and wound care. Best of luck.

Jourdan Gottlieb, MD · Answer

The blood flow to the nipples was diminished enough that some of the skin has not survived. The good news is that the nipple appears to have enough blood supply, and once this is healed it will probably not look much different than if nothing like this had happened. 

	It might speed up the healing if your surgeon would remove the black tissue which is  dead skin. This requires wound care, but not surgery.  If at 6 months the outcome is not satisfactory, that would be the time to consider a touch up surgery. 

	All the best.

Darryl J. Blinski, MD · Answer

Unfortunately you had/have a post operative complication of wound edge and nipple necrosis. Aggressive daily care and weekly office visits is indicated. Healing scan take a month o more. Sorry for the issues.

Samir Shureih, MD · Answer

It is not very common to see areas of necrosis of the nipple areola after gynecomasia surgey.

	You do have some areas of skin necrosis. There is nothing that can be done now other than wound care, and the tincture of tie and see what would be the final results. After complete healing then revaluate, amy be a second opinion and try to remedy the situation.

What's Going on with my Nipple? (photo)

Answers (11)