Scar tissue blocks feeling in my nipple. Could I get this removed during a BA?

Question

So this is a unique problem. When I was much younger I had my left nipple pierced twice. It never really healed right and I finally took it out and it's been out for about 6 years. Basically a bunch of scar tissue formed at the bass of my nipple (internally) and I have no feeling in the middle of my nipple, and then I regain it at the very tip. My left nipple feels like it has a hard little ball in it. Would surgery help this problem? Could I do it during a BA?

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello again Gisselle.  Your nipple scar can be addressed during a breast augmentation surgery, but there is always a risk of scar recurrence and further nipple sensation changes.  In terms of the breast augmentation itself, I would first have a detailed discussion with you to clearly define your desired breast outcome goals – this would include the size you would like to achieve, and your ideal breast shape.  I would then select the best breast implant for you based on volume of the implant, projection of the implant, contents of the implant (I typically place silicone), shape of the implant (round or anatomic), surface of the implant (I only perform smooth), position of the implant (over or under the pectoralis muscle), skin stretch of your breast (more stretch would require a larger volume to fill, as in your breast), degree of breast sag (which would benefit more from a lift), breast diameter and overall chest circumference, native breast tissue volume, and any history of prior surgery or trauma to the breast.
The next step for you is to seek out a board certified plastic surgeon who specializes in aesthetic plastic surgery.  In your consultation, be sure your surgeon addresses all your concerns and discusses the surgery details including the position and size of the incision used, the type of breast implants available, the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar breast appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. 
  
And lastly, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired breast outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.  
  
For more information on breast augmentation, please refer to my link below.
  
Good luck.  
  
Mark K Markarian, MD, MSPH, FACS 
  
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Finny George, MD · Answer

Hi, thank you for sharing your question. While breast augmentation may be something that you wish to pursue, the removal of scar tissue without and around your nipple will not improve (and may even worsen) the sensory loss. Sensory loss that has been present for this long time period is unlikely to recover. 
Consult with a board certified plastic surgeon to discuss this further after a physical exam. I hope this helps. Best of luck!

Gary Lawton, MD, FACS · Answer

Surgery will replace the scar you already have there with another one.  Since you have feeling I would not suggest surgery since things will be very much the same with the risk of losing sensation.

Stephanie Peng, MD · Answer

Hi there, thanks for your question. Removal of the scar tissue during breast augmentation is possible, but it's more likely to increase your numbness rather than decrease it. Even if you keep your scar tissue, the augmentation itself can cause nipple numbness. This is rare, but it's one of the risks of surgery, because if the implant is large enough, it'll stretch the nipple and cause numbness.  When you consult with your board-certified plastic surgeon, be sure to discuss this problem in detail.  Good luck!

Pejman Aflaki, MD · Answer

Hello and than you for your question. I would avoid remove the scar tissue in the nipple area. I would seek consultation with a board-certified plastic surgeon for a full evaluation and advice. Best,
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Veerle Rotsaert, MD, FEBOPRAS · Answer

Thank you for your question. Sorry to hear about these nipple piercings causing such discomfort.
In your situation I would strongly advise against surgery to your nipple. I would embrace the little sensation you still have left. Further nipple surgery comes with new scar tissue which could likely alter if not decrease the nipple sensation even more. 
Make sure you have your breasts checked regularly!

Marc Pacifico, MD, FRCS(Plast) · Answer

Many thanks for your question. Unfortunately it is unlikely that any surgical procedure will improve your nipple sensation - in fact, it may further reduce it. I would therefore recommend avoiding any further surgery.Sorry if this is a disappointing answer!

Farid Brad Mozaffari, MD · Answer

Hello. This is not a straight forward issue.  It depends on what is causing the numbness.  More often, the numbness is due to injury to the nerve and if a nerve has been cut or permanently damaged/entrapped in scar tissue, then it is very unlikely that scar removal will restore sensation.  Nerves at that level are too small to be dissected out of scar tissue and freed up.  Less common cause would be scar tissue putting pressure on a nerve.  In that case, removal of scar tissue will restore sensation.  No way of telling which one is causing your problem unless the scar tissue is removed and then see if sensation returns after a few months. In most cases, scar tissue removal can be done at the same time as a breast augmentation.  As stated by others, it is best to see a board certified plastic surgeon to go over all your options.

Daniel Barrett, MD · Answer

Dear gisselleishere,
any procedure can cause numbness in that area. There is a chance that even after surgery, you won't be able to feel that part of nipple or even wider area. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question.  It may be possible to do during your BA but it all depends on the extent of scarring and your understanding that removal may lead to further alterations in nipple sensation.

Scar tissue blocks feeling in my nipple. Could I get this removed during a BA?

Answers (14)

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