Is my Free Nipple Graft Failing? (photo)

Hi. I've recently had a double mastectomy. I'm FTM transgender. I'm three weeks post op. The doctor cut 3cm wide nipples and put them into 2cm wide 'holes', as they were 'supposed to shrink'. Left one did, but right one only shrunk a little and then got 'droopy'. It'd bleed a little from the underside and some from around the actual nipple (brownish). Now, the upper part cracked and I think I can see my flesh underneath. I'm freaking out big time. My doctor is not seeing me until Monday. Help.

Doctor Answers 9

Free nipple grafts

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.

San Antonio Plastic Surgeon
4.9 out of 5 stars 133 reviews

Nipple loss after FNG

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.

Richard A. Bartlett, MD
Brookline Plastic Surgeon
5.0 out of 5 stars 10 reviews

Nipple loss after FTM surgery with free nipple graft

 From your photo, it does appear that you are losing most of your nipple graft. However, you may still retain enough tissue for a nipple areola. Right now, the important thing is to keep the area clean, and to use an antibiotic ointment. Please let your doctor know what is happening. If you do lose the nipple, a new one can be reconstructed much the way we create nipples for cancer reconstruction

Karen Vaniver, MD
Kennewick Plastic Surgeon
5.0 out of 5 stars 36 reviews


Unfortunately, it appears that the majority of your graft has failed. Don't panic, be patient it will heal up over the next few months and some revision all procedures can be done, including skin grafts, scar revision, and possible tattooing. Make sure you see your surgeon ASAP! 

Michael S. Beckenstein, MD
Birmingham Plastic Surgeon
4.9 out of 5 stars 18 reviews

Top Surgery

I appreciate your question.
Please follow up with your PS

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 83 reviews

Failed free nipple grafts

When a nipple graft fails, the loss of the natural nipple and areola can be replaced with a reconstructed nipple and areola. Current techniques give very real-appearing nipples with a surgery that is done in the office under local anesthesia . The areola is simulated with a tattoo. Some tattoo artists can are so skillful that they can create a 3-D appearance of a nipple, which makes the nipple reconstruction surgery unnecessary, however the 3-D nipple tattoo will not project forward to give a natural appearance in a T-shirt.

Hopefully, considering the date of your inquiry, you have already completed your reconstruction. My response may be of help to others looking at this question.

Sheldon Lincenberg, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 25 reviews

Free nipple grafts

It is difficult to tell how viable the nipples are based on the photos you provided.  It is best to keep the area as clean as possible and see your surgeon.  

Josef Hadeed, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 10 reviews

Nipple Graft Viability

Hi Charlie,

Thanks for the post and photo. It appears that you are having some compromise to your nipple and areola. The black area will eventually separate and you will either have an open wound or new formed skin. Either way, the results should not be affected too much and down the line, medical tattooing can restore the color to the areola as need be. I recommend that you follow your doctor's advice as far as any creams or wound care that needs to be done.


Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 44 reviews

Nipple graft failing

It is difficult to say. However, even if it failed partially or completely, you can always get medical pigment tattooing, so don't worry.  See your doctor. There is nothing to do at this time anyway.


Gary J. Alter, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 20 reviews

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.