Nipple Badly Scarred

I had a breast lift about a year ago. I'm satisfied with the overall shape but the right nipple had terrible scaring. It is surrounded by scar tissue now with only a little nipple tissue in the middle. I tried nipple tattooing but it didn't seem to take and I would prefer to have actual nipple tissue if possible. I read you can have it stretched and cut out the scar tissue. Is that true? I'm really embarrassed by the way it looks now. Please help.

Doctor Answers 7

Areolar reconstruction can be done with skin grafts

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

You appear to have a significantly scarred areola within a standard circular areolar closure. This may be due to delayed wound healing or another post-op healing issue. The best way to get a nice round areola on that side is  to remove the scarred areolar skin completely and replace it with a skin graft from the groin which has a slightly darker color than the surrounding breast skin. A difference in pigmentation compared to your opposite areola could be corrected by a medical tattoo artist.

Areola Reconstruction?

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

Thank you for the question and pictures.

Although skin graft reconstruction is an option that potentially will improve the appearance of the scarred areola,  I'm concerned about the aesthetic appearance of the skin grafted area.  if you're considering this option,  make sure you see lots of examples of the plastic surgeons previous work;  realistic expectations are very important to avoid disappointment later.

Best wishes.

Nipple areolar scarring

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I am sorry to hear about your problem. When the nipple scars well, it scars amazingly well and, when it scars poorly, it can be horrid. I do not believe that scar revision will improve this condition, which probably resulted from a slough of the nipple tissue. You should consider a skin graft to this area to recreate the nipple and to have tattooing to restore the shape and color of the areola.

Areolar loss

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

first the good news. youe nipple is ok. A ftsg from inner thigh or labia minora with nipple preservation will be required to achieve as normal an areola as possible. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Nipple (areola) Badly Scarred

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

I agree with the other 2 doctors; if you choose the skin graft route, you may want to consider using your labia minora skin as it is contractile tissue and actually makes a very nice areola.  Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 reviews

Nipple scaring is due to ischemia

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

Your pictures show nipple-areola scaring and it can be due to infection or ischemia. The most common cause of this is blood flow compromise during the surgery. The scar revision will not work well and you may try split thickness skin graft.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

Your areola appears too scarred to be advanced into the size of a normal areola

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

Your affected areola appears too scarred to be of sufficient elasticity to be advanced into the size of a normal areola.  Based on your photos I doubt that a scar excision with an attempt at areolar advancement will work.  While you have already tried tattooing, repeated application of tattoo pigment may augment the color contrast of the psuedo-areola and further camouflage the existing periareolar scar. Alternatively, consideration  for a full thickness graft reconstruction of the areola can be considered.

Chen Lee, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 21 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.