1 Day PO- Does A Black Nipple Mean Necrosis Following Mastopexy/Augmentation?

I just had a breast mastopexy and augmentation yesterday. Today I notice that the left nipple turned black but the areola is still pinkish. My doctor is away for three more days so won't be able to see me right away. Is there any rush to go in for medical help today versus waiting three days? Anything different that can be done now versus in three days, or any likely difference in the outcome?

Doctor Answers 10

1 Day PO- Does A Black Nipple Mean Necrosis Following Mastopexy/Augmentation?

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Based on your description, I am very concerned about the blood supply to your nipple.  Call your surgeon and discuss/show your concerns even if it is with the surgeon covering him/her at this time.

Breast Augmentation - Does A Black Nipple Mean Necrosis?

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Yes, actually there is urgency in addressing your concerns.  If your surgeon is away then there will normally be someone available as coverage; either an associate in the same office as your surgeon, or a nearby surgeon who has an informal coverage arrangement (it doesn't sound like there is a formal arrangement in place).  You should contact your surgeon's office and ask for help in this but if you cannot get the name of someone who is covering, then you have to start calling plastic surgeons in your area, explain the situation, and make sure that you're seen as soon as possible.  There may be additional costs associated with this but your description of a "black" nipple is worrisome.

That's not to say that it is definitely a problem - there's no way that can be addressed via this forum.  Applying nitropaste may help increase the vascularity of that region and it may be fine even if you do nothing at all.  But a mastopexy with breast implants is one of the trickiest combination procedures and among the risks are decreased blood supply to the nipple and areola.  In the event that this occurs, the area may appear darkened and, for that reason, I agree that you need to be seen right away.

I hope that this helps, and good luck,

Dr. E

You should see a surgeon soon

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You have nipple ischemia or necrosis .You should call your surgeon and see the surgeon that providing coverage. You may need no treatment,but your surgeon should make that decision. 

Nitro Paste Sometimes Improves Blood Flow In Ischemic Breast

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If your areola is pink, there probably is adequate blood supply to your nipple.  If your surgeon is away, there should be someone covering his/her practice and you should call.  I have sometimes used a topical nitroglicerine to successfully improve an ischemic nipple-areolar area, but this needs to be started very early on.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Black Nipple after Mastopexy/Augmentation?

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 Thank you for the question.

It is unusual to have a nipple turn “black” while the areola remains “pinkish”. Nevertheless, for concerns like this one day after surgery is best to be seen immediately;  your plastic surgeon likely has coverage if he is away ( Call his/her  office to check who is covering the practice. Online consultation is just not sufficient  with your description and at this stage in your recovery.

Best wishes.

Nipple necrosis

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You should seek attention right away. Your surgeon should have another surgeon covering for him while he is away. 

Black Nipple Following Mastopexy/Augmentation

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Sorry for your distress. It is an unusual situation, and one that should be checked as quickly as possible. Your surgeon should have another surgeon covering his practice while he or she is away. If he or she does not have a surgeon covering for him or her, see if there is an experienced nurse who can check the progress. If there is no experienced, visit your local hospital and ask to consult with the plastic surgeon on duty. On line consultation is insufficient.

Black nipple

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A truly black nipple is something your surgeon should be notified.  He/she will often see you that day. The pink areola indicates blood flow, but it can be sluggish venous flow that can cause nipple demise. Call your surgeon or his back up,

Black nipple after surgery

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If you have a black nipple you should be seen immediately by a surgeon to evaluate the viability of the nipple.

Call covering surgeon

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You need to find out who is covering for your surgeon and be seen urgently.  It is concerning that your nipple has turned black.

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.