Nipple Loss from Breast Reduction and Lift

Question

How often does nipple loss from breast reduction or breast lift occur? Why? What can the patient and surgeon do to prevent it?

Brent Moelleken, MD · Answer

Complications can happen in any surgery, although they are uncommon.
Certain factors increase the risk of complications such as smoking, excessive weight of the patient, previous surgery, presence of implants particularly in the submammary position, aggressive surgery, and severe cases of droop / excess breast tissue, health problems, etc.

Jed H. Horowitz, MD, FACS · Answer

All surgical procedures carry some degree of risk. Any breast
operation can result in changes in sensation. This happens less with lifts than
reductions but is still possible. Occasionally, minor complications occur and do
not affect the surgical outcome. Major complications associated with this
procedure are rare. The suitability of the breast lift procedure and specific
risks may be determined during your consultation.

Elizabeth Slass Lee, MD · Answer

Nipple loss with breast reduction is a known complication, but is very rare. Smoking, poor nutrition, very long breasts with low lying nipples are all risk factors. Making sure you are choosing a board certified plastic surgeon with experience doing this procedure also helps to minimize your risk for complications.

Farbod Esmailian, MD · Answer

Anything can happen from surgery and you need to be aware with the riks involved.  This happens in less than 1% of cases when it is the first surgery.  That percentage goes up dramatically when the patient has had previous breast surgeries like prior breast augmentation and/or prior lift.  In the secondary cases, it is no possible to entirely predict this which is why the percentages are higher.
This is secondary to inadequate blood supply to the tissue, in this case the nipple.
Hope this helps.

Otto Joseph Placik, MD · Answer

It is difficult to explain this concept but I tend to use oversimplifed analogies. Loss of a nipple is secondary to compromise of the blood supply during an operation. Removing breast tissue also removes some of the blood vessels traveling from and to the nipple. This would be similar to trimming the root ball of a tree. How much of the root ball would need to be cut before the plant dies? What happens if you hit the tap root? Removing too much of the breast tissue can also excise the blood vessels traveling to the nipple resulting in nipple death.

Armando Soto, MD, FACS · Answer

Hi there-
In over 300 of these operations, I have never had a patient experience loss of any portion of their nipple.
Nipple loss (necrosis) occurs due to excessive diminishment of the blood supply to the nipple during the surgery. This is related to the technique and therefore will be also related to the experience of your surgeon.
Most surgeons certified by The American Board of Plastic Surgery should be able to perform these procedures with a very low risk of nipple loss.
Ask you chosen surgeon about it. If you're not comfortable with the answer, look around a bit.
All surgery will have risks, and this risk will always be present with this type of surgery- but it should be extremely low.
For help finding a surgeon you like and can trust, please read this:

Tom J. Pousti, MD · Answer

Although the risk of complete loss of nipple/areola tissue is very small,  this can happen even in the best of hands. Most well experienced board-certified plastic surgeons use every &ldquo;trick&rdquo; available to minimize the risks.

	Patients should  avoid the use of nicotine in any form.

	 As always, surgeon selection is critical.

Leo Keegan, MD · Answer

Nipple loss, partial or complete is rare after breast reduction surgery and even less common after breast lift surgery. Patients should avoid smoking before and after surgery and follow their surgeons pre and post-operative instructions. Surgeons must be technically skillful at preserving the blood supply to the nipple. Nevertheless even healthy compliant patients who have surgery performed by well trained and experienced surgeons can have this complication albeit rarely.

Steven Wallach, MD · Answer

Although death of a nipple can happen after having a breast reduction, I would say that it is extremely rare.  In the majority of healthy patients the risk is low.

Darryl J. Blinski, MD · Answer

The explanation of post operative nipple/areolar complex necrosis is a multi-factorial one. There are many factors that can cause this issue, or combination of them.
1. Surgical technique - removing too much inferior skin causing a 'too' tight vertical closure, leading to decreased arterial (oxygenated blood) to the area. Another technique issue is removal of too much of the pedicle.
2. Medical issues - Hypertension, diabetes (small arterial disease), collagen disorders, blood & bleeding disorders, pulmonary disorders.
3. Environmental issues - Smoking, vitamin use, aspirin use.
4. Post operative issues - dirty recovery area, second hand smoke reasons, poor post operative care. Infections & hematomas causing decreased blood flow to area.
Prevention is a the key. A good medical history, good surgical technique and preparation. excellent follow up care can help alleviate the risks of necrosis of the N/A complex.
Hope this was not too in detail. 
From MIAMI

Nipple Loss from Breast Reduction and Lift

Answers (17)

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