What Can You Do when Your Nipple is Gone After a Breast Reduction

I had a breast reduction about a month ago and they skin graft my areolas and nipples and when the dressing was remove from my areolas and nipples I had to put antibioic cream and a nonstick bandage on it,and when I change my bandage it would pull the burn looking skin off my nipple and areola and now it has pull off all the skin including my nipples.The skin is pink in color with black spots coming.So do this mean I want have any nipples and what can I do to have nipples again.I am african amer

Doctor Answers 11

Nipple Viability Questions - Go Back to your Surgeon

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Without an examination or even photos, it is impossible to give an accurate opinion. The good news is that there is almost always away to address and improve your current condition and expressed concerns. For the best advice return to your surgeon for his/her opinion.

Losing nipples

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
If you underwent free nipple grafting, the graft could die but your explanation is unclear. Definitely see your plastic surgeon for followup. The nipples can be reconstructed if they have been lost but this may not have occurred. You could be seeing epidermal changes and the nipple grafts may still be viable.

Nipple loss after reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From your decription it sounds as though you had free nipple graft and possibly lost the superficial skin (also known as epidermolysis).  I would recommend continuing with the nonstick bandages and closely following up with your doctor.  The loss of pigment is common in free nipple graft in African Americans and is something I discuss with all patients.  You should regain some, if not all, of the pigment over time.  

If the nipple is indeed lost, then you may need a nipple reconstruction.  Your doctor, assuming he or she is a board certified plastic surgeon, will be familiar with this procedure.

Michael L. Spann, MD
Little Rock Plastic Surgeon

What Can You Do when Your Nipple is Gone After a Breast Reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From your description you had an amputative reduction where the N/A complexes were full thickness grafted. Sounds like you are healing slowly. Keep us posted on your recovery. 

Not a good situation. You will likely need nipple/areola reconstruction.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I am sorry to hear that.  It is not good news at all, I'm afraid.  Today, we try to use techniques that preserve the nipple attachment to the underlying tissues.  It sounds like you had your nipples grafted, which leaves them without feeling or function, and jeopardizes their survival. 

There are techniques to reconstruct nipples, but they are never as good as what you had and do not have function and only minimal sensation.  This involves folding the skin in the area where your nipple should be and grafting some pigmented tissue around it.  You can still get a cosmetic result that is at least better than having no nipples.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 62 reviews

Free nipple grafts?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I think that you are talking about free nipple grafts.  If this is the case often they look quite pink and even lose color.  If this is the case give it time to heal.  I would follow closely withyour doctor to make sure everything is OK>

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
After a free nipple graft breast reduction it is very common for the top layers of skin to peel off as you are describing. If the dark spots are coming back thisnmeans that the pigment is starting to return and should continue over the next few months. In terms of the nipple itself there is no nerve function to these nipples so project will be minimal if any.

David L. Abramson, MD
New York Plastic Surgeon

Loosing your nipples after breast reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Sandra,

I am so sorry this happened to you. Unfortunately, this complication is not uncommon using old standard techniques. You will have to wait until you are fully healed, then at a later time consider nipple/areola reconstruction. It is a very simple procedure and gives women a nice result.

Loosing nipple sensitivity and loosing areolas/nipples altogether made me re-design how I did reductions. With my innovative technique, women with extremely large breasts not only keep their own areolas & nipples, but they also have increased nipple sensitivity. This is because I never take their nipples off! I preserve the vascular trunk that allows them to survive.

Pls. don't let this minor set back get you down. Be patient, allow your body to heal itself and allow your surgeon to help you. Best wishes, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Breast reduction and concerns about nipples

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 It seems your had an extensive braest reuction, which required using your own nipple areola complex being grafted in their new locations. Some times it may take weeks to know what part of the graft will survive. During this phase of healing , the only thing you need to do would be to support the healing process. Multiple dresssing changes and topical use of antibiotics are very helpful. After completion of healing the missing part could be reconstructed easily. Please do not smoke if your are smoker.

Nipple reconstruction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Nipple grafts were sometimes used in very large breast reductions when the surgeon was not sure if the blood supply to the nipple could be preserved.  In such situations the nipple would then be grafted.  As with any skin (or nipple) graft, sometimes it doesn't all heal perfectly.  You should wait until the healing is complete.  If necessary, your plastic surgeon could perform additional surgery to reconstruct your nipple.
Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 518 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.