Before and after double nipple sparing preventative mastectomy. What are this risks for nipple necrosis? (Photos)

Question

I had a double profelactic mastectmay 7 days a go. Over the muscle high profile direct to implant 425ccs. I am 5'3'' and 118 lbs and was an a/b size before and now am a 36C. What is the usual timeline nipple necrosis begins? And when do I know I am in the clear?

Stephanie Beidler Teotia, MD · Answer

It is unlikely that you will experience necrosis given the results in the picture. Usually significant discoloration is seen in a necrosis situation. Exciting result!

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. If you are 7 days out from surgery and there are no signs of problems with your nipples, then you are in the clear. If there were problems with blood flow to the tissues, you would know it by now. You look great and you should thank your surgeon.Best of luck!

Allen Gabriel, MD, FACS · Answer

Thank you for your question and pic. Your nipples appear to be healing beautifully as the base of it appears to be viable 7days post surgery.   By now your nipples should have been black if necrosis occurred.    At this point you are in the clear and you may loose some height but otherwise it looks excellent.   Please stay in close contact with your plastic surgeon as the post operative care after such a surgery is important.  best of luck and congratulations on an excellent result and for going over the muscle.  You will be so much happier long term.

Ali Sadeghi, MD, FACS · Answer

Thanks for sharing your pictures. Looks like the nipples are both viable. Its not unusual to have some scabbing at the nipple after the procedure.  The scabs will fall off and the nipple will be viable and pink again.

Emese Kalnoki, MD · Answer

From the post op photo, it looks like your nipples are doing well.  It is unlikely that they will lose blood supply at this point.  Overall, looks like you have a beautiful result!  
Nipple necrosis is usually seen within the first few days after surgery - the areolas may start to look purple or dark red.  Some of those areas may recover, and some don't.  In your case, looks like you will continue to heal well.

Richard J. Brown, MD · Answer

Beautiful results. I love going right to implants in my breast cancer patients and nipple sparing allows for such a better result. So it is totally normal for you to get some crusting of the nipples as early as a week out. There are times when I tell my patients to expect scabs for 6 weeks or more. I do not like patients to pick the scabs off because under a scab is healing. Usually wounds are just healing. Just like when you were a kid and skinned your knee, the scab fell off once it healed underneath, the same happens to the nipple. Even when I work with excellent mastectomy surgeons who are great leaving good blood supply, patients still have issues with healing. So don't be too alarmed if there is some scabbing for 6-8 weeks and eventually thinks will be fine. From your pictures I expect you to have a good outcome. By one week if things are not going to live we know it. Great result!!
DrRickAZ

Before and after double nipple sparing preventative mastectomy. What are this risks for nipple necrosis? (Photos)

Answers (6)

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