Did my nipple fall off? (Photos)

Question

I had DI top surgery 3 weeks ago, and the scab on my left nipple has been progressively peeling off and finished this afternoon, leaving a crater. It also tingles like crazy. I was wondering if this was okay/normal or if my nipple fell off? And if there's anything I can do for it. The right nipple is still scabbed but looks okay.

Josef Hadeed, MD, FACS · Answer

If you have any concerns as to whether or not your nipple is healing you should follow up closely with your plastic surgeon.

Cassie Nghiem, MD · Answer

The nipple graft healing depends on the blood supply from underneath. Commonly, the top layer sloughs off, with fresh tissue underneath. Follow your plastic surgeon's wound care instructions. In the healing phase short-term, I advise patients to keep the nipple grafts moisturized. For long term healing (up to a year after surgery), I strongly recommend sunscreen whenever the scars are exposed to prevent darkened scars.

Sheldon Lincenberg, MD · Answer

In your photo it appears that there is tan nipple pigmentation and this suggests that your nipple graft has taken. 
I would recommend that you discuss this question with your surgeon.

Lisa Friederich, MBBS, FRACS · Answer

Hi, thanks for your pictures. Because a nipple areola graft is thicker than a regular skin graft it takes longer for a new blood supply to grow in. As a result, the top layer commonly 'dies', scabs or sloughs away, but the underlying layers heal. We usually leave any scabs in place and let the wound heal from underneath. In some cases the graft can fail, but there is often secondary scar that grows in which may look ok.  
I warn patients it can take up to a month before the grafts start to look healthy. It can be a prolonged process.
One potential benefit of this technique is that it tends to flatten out prominent nipples. 
My advice is to let your wounds heal and then discuss any concerns with your surgeon.

Babak Dadvand, MD · Answer

Hi cnt027,Thanks for the post and the photos. Based on your photos it looks like your nipple/areolar graft on the left did not take and will now need to be treated with wound care until new skin grow in. This is also likely to be the case for the right but it is too soon to tell as sometimes the NAC grafts do scab over and then the superficial scab comes off over a perfectly normal areola. I recommend you follow up with your surgeon for further recommendations. Congratulations on your surgery!Sincerely,Dr. Dadvand

Sidhbh Gallagher, MD · Answer

I feel for you! It can be very stressful watching and waiting after surgery! My best advice right now? Take a break from the mirror. Its too soon to tell what your final outcome will be. The best plan would be to follow your doc's recommendations for now and let it heal. Most would suggest an antibiotic ointment and a dressing until things are healed over. The tingling is your nerves waking up this too will improve. Several months will pass before we know for sure what that nipple is going to ultimately look like - believe me I have been pleasantly surprised in the past. If your aren't happy with it ultimately it can be fixed. I hope this helps! Best of luck!

Did my nipple fall off? (Photos)

Answers (6)

More Masculinizing Top Surgery Questions

Can I get top surgery without transitioning?

I am a cis-female but would like to have my breasts completely removed, do I need to find a FTM experienced surgeon?

Female to male: what can I expect from testosterone therapy as far as breast size?

Can I donate my breast tissue?

What is my best FTM top surgery approach? Peri-areolar or DI? (photo)

What type of top surgery do I have a chance at? (Photo)

WE SEND PRETTY
EMAILS