Left Breast Nipple Got Smaller and Darker After Surgery!

My left breast nipple got done surgery four times in 5 months. (one for breast implants, one for remove blood, one for reconstruction, one for explant) My Right side nipple is just normal. But my left side nipple got smaller (almost flat) and darker. Is it possible to get nipple smaller after surgery? I heard when you have flat nipple, you can suspect breast cancer. I'm so scared. Is it related to breast cancer? If not, would it come back to normal? If so, how long will it take it? Thanks!

Doctor Answers 8

Reoperations cause more scar. Scar causes contraction of pigmented tissues = darker.

You have ample surgical history to cause darkening of these tissues (scar contracture causing darkening is a very well-known phenomenon seen in all skin grafts, and commonly used to simulate an areola for breast reconstruction), as well as some degree of retraction and flattening. You haven't had skin grafting, but you have certainly had enough surgery to cause scar contraction! You already provide the reason--the areola is smaller, so the pigment in your areola is "concentrated" in a smaller area, making it appear darker!

Your comment about cancer suspicion applies only to retraction and flattening when there is NO other identifiable cause. You should have no higher concern than before your breast surgeries, but you should not be falsely reassured--you must still do your breast self-examination, and routine mammography according to you own physician's recommendations, based on your own medical and family history and prior breast examinations.

As scar tissue softens and matures over the next 6-12 months, you may see your nipple/areola complex stretch out some, and lighten as the pigment is distributed over a larger area. (Contraction over a smaller area is why the color "appears" darker now).

Rest easy, and get better from your breast surgery marathon!

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Nipple CHanges After Breast Augmentation

Changes in nipple size and color may have occurred from damage to the nerve, which may be temporary or permanent, or from changes in the skin stretch accompanying implantation, bleeding, explantation and scarring. If the nerve is the cause, you would also experience numbness, which may also be temporary or permanent. Certainly, nipple changes can occur with cancer, but are more often dimpling or nipple inversion. Time and massage will be of help to you.

Karen Vaniver, MD
Kennewick Plastic Surgeon
5.0 out of 5 stars 37 reviews

Nipple areolar changes can occur after repeated surgeries

You have had a difficult post-op course with 4 surgeries in 5 months. It's difficult to say what the exact cause is of the the left areolar darkening and size reduction. Certainly after 4 surgeries in a short period of time this is not terribly unexpected. The possible causes can be scarring, infection, decreased blod supply, and just trauma from repeated surgeries. It is too early to know how it will eventually heal. You need to wait at least 1 year from the time of the last surgery before you know whether htese changes are permanent or not and whether you may need corrective surgery of the areola. Whatever you do make sure that you do not intervene surgically at the present tiem as this would probably aggravate the problem. If you are comfortable with your surgeon you should ask for his advice and you should be followed every few months by him. You also may want to double check to make certain that your treating surgeon is a Board Certified Plastic Surgeon. Good luck.

George Lefkovits, MD
New York Plastic Surgeon
3.8 out of 5 stars 46 reviews

Nipple changes after breast surgery

Sounds like you had a real bad time.

It is difficult to advise from the amount of information you have provided. There may be a very innocent explanation i.e. scarring from repeated surgery (I assume your scars are at the margin of nipple/areola). It somehow does not sound like a cancerous change (it will be an extraordinary coincidence if it was) or a circulation problem.

So please see your surgeon or provide us with more details of the operations/complication(s) and current problems, preferably with some photos.

Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon
4.8 out of 5 stars 32 reviews

Nipple issue after cosmetic or reconstructinve breast surgery

It's unfortunate that you've been through so much in such a short amount of time and the probable answer to you is that it may be a long time before things are fully healed.  There are many reasons why the nipple's appearance changes after surgery- sometimes the reasons are simply due to a change in the 'stretch' of the skin (a stretched areola tends to be lighter) and sometimes the answers are not so simple.

The one thing I can tell you is that, although breast cancer issues can never be ruled out, if you didn't have breast cancer before this and if the surgery you had was all done for cosmetic reasons, it's unlikely that the issues you're experiencing are cancer related.

My recommendation to anyone I see who has already had two surgeries and is expecting to have a third procedure to correct issues related to the first surgery, is to get another opinion.  Although your first surgeon is probably handling things for you correctly, sometimes it's helpful to get another perspective.

I hope this helped.

Scott E. Newman, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 42 reviews

Nipple changes after multiple breasts surgeries

I have seen changes like this in patients after removing an implant, in my patients' case, for infection. The resulting scarring caused the areola, which is the pigmented area around the nipple, to contract and shrink in size. This made the pigmentaton appear darker. When we eventually replaced the implant and the areola stretched out, the pigmentation and size matched the other side quite well. You should be aware, however, that after so much surgery on your left breast, there will be more scarring there than on the right, so there will probably always be some differences between your two breasts--as is true for most of us. Our left and right sides never match perfectly.

Margaret Skiles, MD (retired)
Sacramento Plastic Surgeon
3.6 out of 5 stars 13 reviews

The reason can be the loss of circulation

I am sorry that you had to go through multiple surgeries. The reason for the change in the nipple size can be due to scarring or loss of circulation. You need to follow up with your surgeon and the risk of breast cancer can not be ignored.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Nipple problem after four breast revisions

With the information you have given it is impossible to know what is causing the issue with the nipple. We can see that there is increasing risk to the breast with four breast implant revisions in a five month time span. If you have confidence in your surgeon keep in contact, though a 'check-up' on your surgeons credentials might be in order. Board certification will give more assurance of seeing the issue safely through.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.