Botched FTM Top Surgery. What could be done to fix it? (Photo)

Question

Hello, I had top surgery on January 16th of this year, and I would like an opinion about my chest. I think I should have done a double incision, but the surgeon insisted on peri-areolar, I know it is too soon, but there are any chances my skin will be flat and not wrinkled like in the photo? If not, what could be done to fix it? Also, my left nipple died, he says it was not his fault, it was just a complication that happened, what could be done to fix the nipple when it closes and heal completely?

Rukmini S. Rednam, MD, FACS · Answer

Hello,Based upon the one photo is is likely for the best contour a double incision surgery may have been a better initial choice.  However I would not get too worried.  With time your swelling will subside and you will experience some skin retraction once the tissues are softer and less inflamed you can return and still perform a double incision surgery with a free nipple graft on the viable side and a nipple reconstruction with 3D tattooing on the side with your nipple loss.  I would recommend a board certified plastic surgeon for your revision surgery with experience with Top surgery.  Best of Luck with your healing!Dr. Rednam

Gary J. Alter, MD · Answer

You probably should have had a double incision with free nipple grafts as your skin will almost certainly not shrink enough to be flat. You still can. Your surgery can be converted into the double incision and the remaining areola might be able to be removed and placed as a graft. Otherwise, an areolar reconstruction can be done.Gary J. Alter, M.D. 
Beverly Hills, CA - Manhattan, NYC -  Dubai, UAE

Jaime Caloca, Jr., MD · Answer

Although healing has not completed, you may require revision surgery in order to improve your results. If results do not improve at three months post-op, then the Double incision mastectomy with bilateral Areola-Nipple reconstruction will provide great results. The A-N reconstruction can be done with Labia Minora Grafts for the areola and Nipple graft from the surviving nipple.

Giancarlo McEvenue, MD, FRCSC · Answer

Hello,
Sorry about your poor result. It is definitely possible to fix if you go to someone with lots of revision Top Surgery Experience. The key would be how loose the skin is on your chest and how much breast tissue is left. if the answer to both is lots then I would recommend a DIM. if the skin is tight and there is not much breast left then I would recommend a keyhole approach.SincerelyDr.G

Tracy Kayan, MD · Answer

Your surgery was fairly recent, so it would be prudent to wait at least 6-12 months to have a revision. Your results can definitely be improved, so do not despair. Even though the nipple was lost on your left side, it may be able to be placed as a graft, and your current results can be essentially converted to the double incision surgery you may have been a better candidate for in the first place. If the nipple and areola are in too poor of a condition to be grafted, nipple and areola reconstruction can be done by a plastic surgeon experienced in this. There are options, but wait to heal from this most recent surgery before pursuing any revisional procedures.

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