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

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.

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.

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

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.

Sincerely,

Martin Jugenburg, MD

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.

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.

From your description, it is not clear whether or not you truly have "lost" your nipples. You might have just shed the top layers of skin which seems to fit the situation that you have described (including the loss and then some reappearance of pigmentation). My recommendation would be to wait at least 4 - 6 months to better determine what you are left with. Of course, you should be asking your plastic surgeon exactly what your situation is with regard to the nipples.

If they have survived except for loss of pigmentation, then tattooing can be done to address this. If there is significant loss of the nipples themselves, then there are reconstructive techniques that can help recreate new ones.

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. 

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>

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.