Is my Nipple Dying After Breast Reduction? (photo)

Question

I had breast reduction surgery on November 9, 2011. Today is November 19, 2011. My surgery did not include a free nipple graft. I am concerned about the status of my nipple. It looks markedly different from my other nipple. Is my nipple dying?

J. Jason Wendel, MD, FACS · Answer

Only time will tell, but it does appear that a portion of your nipple has lost blood supply. How much will survive is unknown. Follow the wound care regimen that your surgeon prescribes for you. I wish you a speedy recovery.

Ricardo A. Meade, MD · Answer

Yes, it pretty much appears that way. Go back to your doc for wound care and stay away from smoke. The result will still be reasonable but you may keep the hypopigmented (pale/pink) coloration to the skin in the area where the nipple didnt' survive.

Steve Laverson, MD, FACS · Answer

In agreement with other responders, your plastic surgeon needs to evaluate and manage this situation. If you are smoking, STOP! If you are around second hand smoke, get away from it. The areola doesn't appear normal, and treatment will depend not only on what it looks like at any given moment, but changes that become apparent over time.

Marialyn Sardo, MD · Answer

The photo suggests that at least the superficial layer is being shed which may be from a decrease in blood flow. It is difficult to assess how deep and how much of the skin is affected. You will certainly want to keep this area clean and moist. Your doctor should see you to evaluate and make recommendations for wound care to optimize the healing of this area.

Brian Klink, MD · Answer

The photos shows significant areas of poor blood flow/ischemia. How much of the nipple will survive is difficult to determine and will need to be closely followed by your surgeon. Good Luck!

Darryl J. Blinski, MD · Answer

Appears as a deep second degree to third degree burn. Seek immediate care for this or you could have a full nipple necrosis.

Robert L. Kraft, MD, FACS · Answer

The photograph demonstrates the result of poor blood supply to the nipple areolar complex after breast reduction surgery.  This is not to say that the nipple will entirely slough.  Your plastic surgeon may want to treat the wound and you should be seen postoperatively for assessment.

Tom J. Pousti, MD · Answer

Thank you for the question and picture.

	Based on the picture and a description,  it seems very likely that there have been blood flow ( arterial and/or venous)  problems to the nipple/areola. How severe the problem is will be best determined by your plastic surgeon who can examine you in person.

	Hopefully, the problem involves a superficial skin (epidermis)  and is not full thickness. if so, the dark layer will separate and the underlying tissue will be healthy.  If the problem is more severe than full thickness skin loss may occur.

	Since you are 10 days out of your surgery there is probably no intervention that will be helpful at this point.

	I would suggest continued follow-up with your plastic surgeon who is best served to answer your questions and get you through this stressful period.

	Best wishes.

John Whitt, MD (retired) · Answer

From your photo it certainly appears that you have at least some superficial necrosis of your nipple areolar complex. This can occur following any breast reduction regardless of the technique employed. It is relatively uncommon in most cases, but certain conditions (especially smoking) can increase the posssibility of this problem.

Is my Nipple Dying After Breast Reduction? (photo)

Answers (9)

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