Do I have nipple necrosis? 3 days post-op. (photos)

Question

I had breast augmentation with mastopexy 3 days ago. Yesterday, as I was changing my dressings, I noticed that the left side of my areola was darker than the other side. I contacted my surgeon immediately, and he ordered NitroBid ointment to be applied to the area twice a day. Im still very concerned about it, but he thinks that it's fine. It's also oozing what looks like dark blood.

M. Scott Haydon, MD · Answer

Thanks for your question and the photo. You will likely lose the superficial skin, but unlikely it is complete loss. The Nitrobid can definitely help. Your swelling likely has peaked and hopefully things will start improving. Your surgeon should see you sooner than later. Best of Luck!

Vishnu Rumalla, MD · Answer

Thanks for your inquiry and pictures. I am glad you are communicating with your surgeon and nitrobid can help.  It is a difficult diagnosis to make from a picture, please continue to see your plastic surgeon and best of luck.

R. Scott Yarish, MD · Answer

I hope the NitroBid helped.  It appears from the photos that change noted within on day doesn't bode well for that 1/3 of the areola that has defined itself.  Good news is that the rest is ok and can the problem area can be repaired in expert hands.

Sugene Kim, MD, FACS · Answer

Based on your photos and description, your nipple areolar complex seems to have a vascular compromise.  It is good that you are communicating with your plastic surgeon.  Although you may experience superficial epidermolysis, nipple areolar complex will likely heal well.  Please follow your plastic surgeon's post-op instruction and follow up with him/her closely.Best wishes.

Cain R. Linville, MD, FACS · Answer

It certainly appears that your nipple is ischemic, and likely this is from venous compromise.  There are some options for treatment, and some of those include nitrobid, if it doesn't get better, then you may need some of the sutures removed to help with blood flow.

Alejandro Galvez, MD · Answer

Since you had a mastopexy depending on the technique your surgeon used, some vascularity was removed; however the superficial skin of the areola and sometimes even the nipple can suffer a partial loss during the first weeks, specially when the swelling peeks. In your case it looks like it will resolve as it evolves, but im sure your surgeon has this covered already. Best of luck!

Steven Turkeltaub, MD · Answer

Your photos show impaired viability of the nipple-areola complex though without an examination it is difficult to accurately comment on the presence necrosis. Contacting your plastic surgeon immediately was very wise and the instructions to apply nitrobid paste was a great choice.Follow up very closely with your plastic surgeon. This situation can ultimately turn out better than you may be expecting now. If not, there are still ways to give you a nice result.Steven Turkeltaub, MD

Do I have nipple necrosis? 3 days post-op. (photos)

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