Is my Free Nipple Graft Failing? (photo)

Nipple grafts can have this appearance after double incision mastectomy.  Typically we use silvadene cream on the grafts from the time the dressing are applied in the operating room until they are fully healed.  If yours have been left dry, like it appears they have, it might separate, and the resultant nipple may be smaller than it may have otherwise been.  There is no need to panic however.

It is hard to tell from your photo but is looks like some part of the graft didn't take. I would let your doctor know immediately so that they can make specific recommendations regarding care of the site. Even if you loose the nipple a new one can be made.