Black scab around nipple seems to be getting worse I think. What went wrong? (Photo)

I'm very worried that it looks worse instead of better. There is separation around the nipple and at the top of the T should I be worried. I am not sure what to think. I'm exactly 1 month post op what went wrong? My other nipple is fine.

Doctor Answers 9

Sad complication

This may happen, not necessarily your surgeon's fault, which technique was exactly used to make the T pattern? I mean which vascular pedicle was used? this would be interesting to know... Robbins, McKissock, upper, Skoog, Strombeck, etc?

Follow each and all of your surgeon's instructions.

Spain Plastic Surgeon
4.9 out of 5 stars 45 reviews

Necrotic nipple

This is necrosis of the nipple that is the result of the combination of the lift procedure with implants and compromise of the blood supply to the nipple.  It needs to be debrided, although the fact that there is an implant under the wound makes this a logistical problem.  Exposure of the implant will require its removal.

Gary Lawton, MD, FACS
San Antonio Plastic Surgeon
4.9 out of 5 stars 136 reviews

Skin necrosis

So very sorry that you are having this issue. I would suggest meeting with your surgeon and discuss what will need to be done. You lost some of your tissue from a lack of blood. Your tissue around the area looks like it is healing. Once your tissue has healed, the area can be revised to look much better.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Tissue loss

This appears to be a rather significant complication of your procedure known as tissue necrosis--loss of tissue that has been deprived of its needed blood supply. From the looks of the posted photos, all the damaged tissue is already lost--the surrounding skin appears pink and normal. 

Seeing your surgeon for close follow up is essential so that a plan can be made to deal with this problem. once all is healed it is most likely that you will need a touch up procedure. Sorry to see this problem. Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Black scab around nipple seems to be getting worse I think. What went wrong?

Sorry for your very serious post complication of 50% N/A loss and wound dehiscence. Has your chosen surgeon explained what was happening? If not I recommend you have an in person serious discussion..

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Areola Necrosis after breast lift

Unfortunately, calling it a "scab" or "non-healing" is an understatement. It appears taht you have tissue necrosis of your areola from lack of a good blood supply. You should see your surgeon right away and get a treatment plan. This may involve removing some of the remaining sutures to limit the damage, or debriding the necrotic tissue. You need to expect to need a few procedures to fix this. 

Matthew Schulman, MD
New York Plastic Surgeon
4.9 out of 5 stars 326 reviews

Separation and nonhealing is what is shown

Discuss with your surgeon if debridement (removal of the scab) is in order or scar revision and timing. Although scabs can be disconcerting the t junction is the most common area for this. Often closure after the wound is healed and possibly a scar revision can return the appearance to within normal limits.

Peter J. Capizzi, MD
Charlotte Plastic Surgeon
4.9 out of 5 stars 87 reviews

Healing complication

It looks as if you have had a breast lift with an augmentation. The photos show what is called tissue necrosis, which is loss or death of tissue. This is localized to a portion of the nipple as well as some surrounding breast tissue. Typically, this will be left to declare itself and separate however at some point in time, it will be helpful to have this non viable tissue removed. This will assist the area to heal faster. This process will take some time. It is important that you follow very closely with your surgeon to obtain optimal wound care and minimize any complications or problems with your underlying implants.

Mitchell Brown, MD
Toronto Plastic Surgeon
4.7 out of 5 stars 27 reviews

Skin loss after lift and augmentation

It appears that some of the skin of the areola has died after the lift and augmentation. This is a known complication of the procedure and happens due to poor blood supply of the nipple and areloa. In order to perform the lift, the nipple needs to be moved. In order to move it up, the nipple and areola needs to be partially disconnected from surrounding breast tissue. This results in a loss of blood supply.
Having said that, the nipple is still preserved. You should return to your surgeon and develop a plan. The "scab" or necrotic tissue needs to be removed. This will then heal. After healing, a skin graft or some other type of nipple reconstruction will make the breast look much better. 

Eric Weiss MD

Eric Weiss, MD, FACS
Orange Park Plastic Surgeon
4.9 out of 5 stars 33 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.