Does this look normal for a breast reduction at 3 weeks postop? I went from a DDD to a C. (Photos)

Thanks for reaching out.  It appears that you are losing your right nipple or at least 60% of it.  This is a rare risk of breast reduction surgery but can happen.  You should stay in close contact with your surgeon and see him frequently for the appropriate wound care.  You may be able to tattoo some color back after some time has passed.I hope this helps :)

Your right areola is suffering from a lack of blood supply. It will heal but it will do so very slowly so be patient with it and follow your surgeon's wound care instructions.

Thank you for your question and the photos.

It appears from your photos that you did have some diminished blood flow to your right areola as your plastic surgeon has stated.  At this point there is nothing more to do then support the area with good wound care.  Typically the area will form a scab or peel and heal underneath depending on how deep the area of tissue loss.  The nipple will likely have a little less projection and the areola will have less pigment.  Sometimes the healing results in acceptable results and if not this can be addressed with tattoo or a skin grafting from the groin.  I've found that at three weeks swelling and the skin wrinkling starts improving quickly.  Seeing your plastic surgeon frequently will get you through the healing and I'm sure they will be happy to address any issues with the areola if necessary.

Best Dr. L

Your PS is correct.  This can happen with breast reduction and breast lift surgery.  Fortunately, the human body is pretty amazing in its ability to heal wounds.  It is already trying to fill in the area of tissue loss.  The normal thing to do is wait until it stops improving and softens up, usually about 6 months.  It may look normal enough after it heals that it doesn't bother you.  If not, skin grafting from the groin (which can be done in-office in many cases) can give an excellent improvement.  Tatooing on scars tends to be disappointing although may be worth a try if necessary.  I would lean towards something like Bacitracin for the open wound or Silvasorb or other ointment meant for open wounds although Aquaphor is pretty benign.