What can I do to heal this? I think its nipple necrosis. Nipple dead after breast reduction. (photos)

Question

I think i have nipple necrosis. My dr keep saying it will be ok let the dark part fall off. Its driving me crazy. What are other options i have to heal this. Its been 3 weeks since this started. Help please

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures. In my opinion, this nipple and skin necrosis resulting in a large wound. You need to have this debrided to allow for complete healing over the next several months.  Good luck

Jed H. Horowitz, MD, FACS · Answer

I'm so sorry you are suffering from this complication. #NippleNecrosis is a rare complication of a #breastreduction. I suggest that you speak with your PS about immediate care for this. You will need to have this necrosis removed. There is a risk of infection while it is there. You will likely need to see your surgeon 2-3 days a week for treatment. You will experience extended recovery time due to your #nipplenecrosis. #Revisionsurgery may be necessary after healing. Best wishes!

Steven Schuster, MD, FACS · Answer

Sorry to see you have had this rare but devastating problem.  Can occur to any surgeon at any time.  I would see your plastic surgeon frequently, at least 2-3 times a week to get this problem resolved and once healed, which may take several months, then you can go on with reconstruction.  Good luck,

Jeremy S. Hurren, BSc, MBBS, FRCS (Plast) · Answer

I am sorry you experiencing this complication. This looks like nipple necrosis. You really need to be under the care of a experienced surgeon experienced in these type of surgical complications. 
Conservative management with out further surgery may be possible but generally it is better to remove the dead tissue which usually does require further procedures. Sometimes this may be possible in an outpatient setting but adequate removal of the dead tissue may necessitate an anaesthetic. While there is dead tissue present there is an increased risk of infection.
I am afraid you must be prepared for this taking some time to heal up, 12 weeks or more is quite possible. 
You should certainly be in regular contact with your surgeon or someone with the experience to manage your wound.
I wish you well during what I am sure is a difficult time for you.

Tom J. Pousti, MD · Answer

I am sorry to hear about the complication you have experienced; this type of complication can be understandably very stressful to patients. At this point, close follow-up with your plastic surgeon will be key. Gentle debridement of unhealthy tissue and/or exposed sutures may help expedite the healing process. Local wound care and dressing changes will vary from one practice to another. For larger wounds, the use of a "VAC"  device may be helpful. Please make sure that you concentrate on good nutrition as well.  You might be  surprised how well the area will heal and how nicely the body tends to "remodel" itself over time. In the longer term of course, you may benefit from revisionary surgery. Again, continue close/frequent followup with your plastic surgeon on a frequent/regular basis. Best wishes.

Darryl J. Blinski, MD · Answer

You need wound debridement operations, a wound vac, daily dressing care. Best to seek other in person opinions. Sorry for your serious postop complications.

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