After nipple and skin sparing mastectomy and reconstruction it is not uncommon to have healing problems. The skin has most of its blood supply removed so sometimes areas of the skin do not survive. The nipple is especially prone to this.
What you are describing sounds like the skin and nipple blood supply has been compromised, however given you are now a month post op most likely things will be ok. I advise you to see your PS to check on your healing though as there is a risk of skin necrosis (death) and this can lead to infection.
It may just be an allergy in which case putting nothing other than vaseline or sorbolene on the breast is a good idea - your PS can advise you regarding this too.
Peeling and scalyness of the nipple and areola - and sometimes the entire breast skin occurs with injury and compromise to the blood supply. This can occur after surgery as well as radiation. Your reaction may be compounded by an allergic reaction. As long as the nipple doesn't turn black and /or tissue doesn't slough off, it should heal with time. Hydrating ointments like you are using will help. Aquaphor is helpful. Consult your plastic surgeon for additional suggestions. Cortisone is helpful with allergic reactions. There are lotions that actually dilate blood vessels and may improve the healing. Good luck and take care.
Hi - it is difficult to tell what type of peeling you are describing without seeing photos. After nipple sparing mastectomy, several factors can cause your skin to peel. Swelling/trauma of surgery alone can cause the superficial layer of skin to peel off as the swelling resolves. You would likely notice this not only on the nipple but on other parts of your breast as well. Sometimes compromised blood flow to the nipple, which is fairly common given you are basically stripping the nipple/breast skin of its blood supply from the underlying breast tissue and muscle, can cause a slightly thicker layer of skin to peel off from the nipple. This is called superficial epidermolysis, and usually a more pink, shiny layer of skin grows beneath this. Local wound care with antibiotic ointment is a good way to care for this. Either one of these conditions is self limiting, but if you are concerned you should contact your reconstructive surgeon.
After a nipple sparing mastectomy, the nipple/areolar skin typically suffers form poor blood flow to the area and it is possible to loose some superficial portion of skin. As long as it is not all the skin that is lost, the area should go on to heal with possible pigmentation loss. Continue the antiboitic ointments and close follow up with your surgeon.
Sounds like a superficial second degree sloughing of the area. Best to see your PS to advise. /////////
Hello! Thank you for your question! It would be recommended to see your surgeon for this issue for evaluation. After a nipple-sparing mastectomy, there is a risk of necrosis of that area. If so, your surgeon will direct you for wound care. Or, if it is a reaction or just dry areas, your surgeon will be able to examine and determine the cause and give further recommendations. Best wishes!