Would a mastectomy be able to remove my HS? I honestly don't care what the scar looks like I just don't want to be disabled.

Question

My HS is unique. I have a reoccurring abecess under my nipple. I don't have any underarm cysts and my groin only has the occasional large zit. The abecess has been removed twice and incised another three times. I've taken many rounds of antibiotics and I've been on ceaste 35 for years.

Leslie Memsic, MD, FACS · Answer

I have seen hidradenitis of the nipple and breast but other sources of chronic nipple infections exist. Removal of the offending duct/s may be all that is necessary to prevent the problem. If the hidradenitis actually involves the nipple areolar complex, surgery may need to be more extensive but rarely requires removal of the entire nipple. If complete nipple areolar removal is required,  a new nipple may be reconstructed and /or tattooed on with generally excellent results - or a portion of your normal one  (depending upon the size) may be removed and grafted (making 2 nipples out of one). Removal of the offending source of infection generally is curative, but true hidradenitis may recur elsewhere in skin not removed - either nearby or at distant locales. Be sure to get multiple opinions from specialists before proceeding with surgery. Good luck and take care.

Heather Richardson, MD, FACS · Answer

Many times, duct ectasia is misdiagnosed as Hidradenitis Suppurativa. It can be treated and usually cured by removing the duct near the nipple that hides germs and allows infections to recurs over and over. Sometimes this is associated with an un even nipple that appears stuck down or pulled in. If this is the case for you, it is an easy outpatient  fix that means you do NOT need to lose your nipple or your breast and should cure the problem once and for all. Feel free to send a picture of the area to see if you are a candidate. I have dealt with this many times and seen patients gone to other doctors who mistreat this by simply draining the infections away from the nipple as they come up, but never removing the root source. Ask to see a "breast specialist" and ask their office if they have seen "duct ectasia" that requires duct excision for treatment of recurrent periareoalar breast abscesses. This is most likely your problem.

Would a mastectomy be able to remove my HS? I honestly don't care what the scar looks like I just don't want to be disabled.

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