What is Making the Tissue on my Right Breast Turn Black? (photo)

I recently had a breast augmentation and made a large jump from 300ccs to 875ccs. Two weeks after my surgery I developed a discolored area underneath my right breast. The area has gotten worse over the course of 2months, my skin went from white (blanched) to purple to black and scabby. My PS told me that it is probably one of the most bizarre things he has seen. I have seen a dermatologist who said the tissue was necrotic, but necrosis normally sets in 2-3 days after surgery. I'm very worried.

Doctor Answers 11

Black tissue anywhere is worrisome

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and you do have a problem.  You must talk to your surgeon to find a solution.  Yes, it may be bizarre but now its his responsibility to help get you through this.  Unless he knows why you developed this problem, its best to remove the implant and debride the tissue and restore your skin integrity.  Consider removing both implants as the size may have had something to do with your tissue loss.  Good luck!

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Needs urgent care!

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You're right to be worried. This problem requires immediate medical attention from a plastic surgeon. 


Joel Aronowitz, MD
Los Angeles Plastic Surgeon

Skin Discoloration After Breast Augmentation

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This is necrotic skin and possibly underlying tissue over an implant. I would advise that you see your plastic surgeon immediately. 

Gustavo E. Galante, MD
Schererville Plastic Surgeon
5.0 out of 5 stars 55 reviews

Breast implants can be too large.

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It appears as though you have a significant problem. Implants that are too large can create pressure necrosis. You should see your surgeon immediately.

Tissue necrosis

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It looks like you have necrotic tissue of the lower breast skin.  You will most likely need to remove the implant and allow the skin to heal once it is debrided. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Skin discoloration after augmentation

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The skin is clearly necrotic. I agree this is rare. Even in the early pictures the skin seems quite thin. It seems its a mater of time that the implant becomes exposed or infected. You may want to consider smaller implants or possibly fat transfer before re augmentation. 

John Paletta, MD
Savannah Plastic Surgeon
5.0 out of 5 stars 21 reviews

A black scab in proximity to a surgical site represents some degree of vascular compromise

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In seen the pictures you submitted, there is evidence of progressive signs of devascularization. Some times large amounts of pressure can overcome the blood flow to your tissues and manifest as the pictures you have summited. The main risk now, is that your implant becomes exposed or you develope an infection. You should be closely followed up by your plastic surgeon.

Ricardo Castrellon, MD
Miami Plastic Surgeon

Necrosis after Revisionary Breast Surgery?

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I am sorry to hear about the complications you are experiencing;  this is indeed a rare complication.  I have yet to see it.  Although online consultants can only speculate as to the  cause of the problem, your plastic surgeon will likely have a better idea of possible causes.

 The main concern, as you know, is that there is an underlying breast implant. If this tissue necrosis is a full thickness problem,  then eventual exposure of the breast implant is a possibility.   This exposure would  necessitate breast implant  removal.

 Although, there may be several ways to handle this complication, it may be in your best interest to have the area excised and closed, even though it will  mean downsizing the breast implant (s).  Doing so now in a “controlled” fashion, before there is an open wounds and/or implant exposure may be in your best interests.

 Again, your plastic surgeon who knows your situation best will be your best resource for precise/meaningful advice;  continue close follow-up with him.

 Best wishes;  hopefully you will achieve your goals in the long term.   Please keep us updated with your progress.


Skin changes after a breast augmentation

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I would return to your plastic surgeon ASAP.  It appears as though the implant might need to be removed the skin closed up over a smaller implant.

What is Making the Tissue on my Right Breast Turn Black?

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This is a patch of necrotic (dead) skin, and this problem really needs to be addressed by your surgeon. The injury appears to be present at the three week photo, and may have been present earlier. If this is not addressed, the possible outcome will be extrusion and loss of the implant, and then a 3 to 6 month wait to replace it, during which time all the tissues will shrink and make replacement with a large implant difficult if not impossible. 

It may not be possible to close this without placing a smaller implant, but that is better than the other possibilities. Be sure to be seen by your surgeon promptly.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.