Nipple Surviving After Necrosis, How Long Does It Take For The Nipple To Return To Its Normal Color?

Question

Hi, after a breast lift my nipple turned black on the outer part of it. Eventually the black scab came off leaving my nipple pink. I have some color coming back in different areas I was just wondering how long does it take for the nipple to get some color. It has been five weeks since my surgery.

S. Larry Schlesinger, MD, FACS · Answer

Mastopexies with or without obvious areola necrosis can show some degree of pigmentary loss.  This discoloration can take up to six months to return to normal, if it is going to return to normal.If you were my patient, I would recommend medical tattooing that matches the uninjured areola color, and can not only fill in areolar color, but cover any scars visible at the junction of the elevated areola and breast skin.  At our surgery center, Jason Dias, CST routinely tattoos any areolar abnomalities not only for our patients, but for other plastic surgeon's patients as well.

Tom J. Pousti, MD · Answer

I'm sorry that you have experienced the complication;  on the other hand, you are quite fortunate that at least partial survival of the tissues has occurred. I would suggest that you wait approximately one year before evaluating the aesthetic results present and before determining the need for further treatment.  You may find that treatment is not needed.

	Best wishes.

Robert L. Kraft, MD, FACS · Answer

The purple coloration indicated poor circulation to the nipple and you are fortunate that the nipple survived.  If the coloration is still a problem after six months, you could consider tattooing to match the color of the opposing breast.

Chen Lee, MD · Answer

Nipple and alveolar color are dependent on normal number and function of pigment producing cells residing deep in the skin. Pigment production from these cells can temporarily cease to function after being stressed by a loss of circulation. A deep injury might reduce the number of these cells and permanently affect your ability to produce pigment. Waiting for more than 6 months or until scars soften and mature is appropriate. If discoloration persists, treatment by tattoo might be warranted.

Rafael C. Cabrera, MD · Answer

the cells that make color (pigment) are the most sensitive to low blood flow. they die first. the fact that the remaining skin survived means that blood flow was restored but only after the other cells perished. hypopigmentation is not going to get better. plan on getting a tattoo. don't worry, it works well.

Peter A. Aldea, MD · Answer

RE: "after a breast lift my nipple turned black on the outer part of it. Eventually the black scab came off leaving my nipple pink. I have some color coming back in different areas I was just wondering how long does it take for the nipple to get some color. It has been five weeks since my surgery."

	Every operation is associated with some loss of normal blood supply to the skin and with it a compromised ability to supply the cells with oxygen. Repeated operation, combination of certain operations and operating on people with a poor blood supply in the skin (smokers and nicotine users) particularly increases the likelihood of skin death (necrosis).

	In your case you appear to have had a partial thickness loss of your areola. The degree to which it will become normal depends on the depth of the skin loss. If very deep to full thickness the pink tissue you are seeing is not normal areola but scar tissue and it would never have the same color as the normal tissue. I would give it 8-12 months to see just where it normalizes. At the end of that period, you and your surgeon may need to discuss areola reconstruction with a full thickness skin graft or tattooing the entire area, should it be needed.

	Good Luck.

	Dr. Peter A. Aldea

Peter E. Johnson, MD · Answer

You certainly have had good fortune as the poor circulation to the nipple has turned around and the tissue recovered. Some color will return in a patchy configuration, though the process will take a year. Some pink areas and pale areas may persist depending on the damage and over-tattoo to restore color can help. In the meantime, you can use a waterproof makeup to conceal.
	Best of luck,
	peterejohnsonmd

Robert M. Grenley, MD (retired) · Answer

You are fortunate that the nipple has apparently survived. Whenever there is some delayed healing or partial loss, some of the pigment producing cells can be lost in the process. This would lead to areas of loss of normal pigmentation. Sometimes this can be temporary and return to normal over many months or even a year or more, and sometimes normal pigmentation will not return. I would give it a good long time before considering any kind of tatooing or other camouflage treatment.

Lori H. Saltz, MD (retired) · Answer

It is unfortunate that you had a complication. You will have patchy colored areolas at best. Much of the pink areas you see now are scar tissue that will turn white as it matures over a year or so. Tattooing or a full thickness skin graft reconstruction might be needed, but it is too soon to tell. I would wait at least 6-8 months.

Nipple Surviving After Necrosis, How Long Does It Take For The Nipple To Return To Its Normal Color?

Answers (9)

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