Do I have what is called necrosis? If so, will I completely lose my nipple/ areola, or can it be saved? What next? (photo)

I'm 7 days PO BR surgery and I believe I'm having a complication of the right nipple/areola referred to as necrosis. 2 days ago the skin began to blister and peel, to today being black and hardened. The PS did a reexploration of the R breast immediately after the initial procedure out of concern over bleeding but there was none, so I initially thought the darkness was because of that. I see her later today for my first post surgical visit but I am scared and want as much information as possible.

Doctor Answers 3

Nipple necrosis

Sorry to hear about your problem.Based on your photos, you seem to have nipple/areolar necrosis.  It is difficult to predict how extensive the necrosis would be.  It may be superficial necrosis vs. full-thickness.  Please follow-up with your plastic surgeon closely and follow her instruction.  You will need local wound care and possible antibiotics.Good luck.

Nipple ischemia/necrosis

Thank you for including photos. It is still too early to tell how much of your nipple on the right side will survive. It can range from a superficial blistering/slough to complete nipple loss. I can say that the pink tissue underneath the blister is a promising sign, but sometimes you really have to wait a couple of weeks for the tissue to completely "declare." It does sound like your surgeon did the right thing in terms of going back in to explore the bleeding, and most of the time this is not likely related to what is happening to your nipple right now.You should of course follow your surgeon's recommendations, but if I have a patient with a similar nipple circulation problem we sometimes recommend nitro paste, warm (not hot) compresses, nipple massage and complete avoidance of tight compressive garments and absolutely no use of nicotine products.

Tracy Kayan, MD
Minneapolis Plastic Surgeon
5.0 out of 5 stars 9 reviews

Nipple/areola necrosis

You have partial loss of the nipple/areola complex. Treat with topical antibiotic and give it plenty of time to demarcate. You may not need any revisional surgery. Best, Dr. Yegiyants 

Sara Yegiyants, MD, FACS
Santa Barbara Plastic Surgeon
5.0 out of 5 stars 6 reviews

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