Are my nipples necrotic? (Photo)

Question

I had breast implants and a lift done 7 days ago. Saw my PS today. He was a little worried at the color but said they still felt warm. Didn't want to remove the tape just yet. I thought it was just dried blood that had turned black since it is black in other places on the bandage. He wants to see me back next week. Any ideas? I am now scared I am losing my nipples.

Vishnu Rumalla, MD · Answer

Thnaks for your inquiry, unfortunately with all your dressings and tape it is hard to tell what is going on, but if your plastic surgeon is concerned it should be observed very closely.  I wish you the best of luck.

Austin Hayes, MD · Answer

Thank you for your question. Your nipples appear particularly dark and a thorough assessment is required by your plastic surgeon. Your dressings and all adherent blood should be removed for a proper assessment of the blood flow. I would not wait any longer to be examined.

George Marosan, MD · Answer

Thank you for your question and photos. Although there's old blood on the steristrips, it seems that you have nipple/areolar necrosis. This should've been treated right away, by removing the dressings, cleaning the area to correctly assess and evaluate blood flow to this area. Waiting another week, I'm not sure it is helpful. You would've benefited from hyperbaric oxygen treatment (might be somewhat late now, but it could still promote healing and further tissue loss). Need to see your surgeon, now, not a week later. Ask to be seen today! Good luck with your healing.

Matthew H. Steele, MD · Answer

Thank you for your question and photos.  I am sorry to hear about these problems postop.  It is a little hard to tell with the blood around the dressings, but I am concerned that the nipples have turned black due to impaired circulation (necrosis).  Only a thorough, in-person exam can give you the best advice, so I wanted definitely see your surgeon ASAP.  Good luck.

Curtis Wong, MD · Answer

of how healthy your nipples are.  Your surgeon will have to remove the dressings to get a more definitive idea.  You can try cleaning the exposed nipple with peroxide and water and see what color it is and whether it blanches or not as blanching and warmth to touch are encouraging signs.  Hope its good for you.

Robert M. Kachenmeister, MD · Answer

Thank you for reaching out and posting photos. Sorry you are experiencing this. From looking at your photos, it does seem you may have partial or total necrosis of the nipples. I would suggest that your surgeon consider hyperbaric oxygen therapy which may salvage some of the compromised tissue, this should be done sooner rather than later. Best of luck. Dr. Kachenmeister

Richard P. Rand, MD, FACS (retired) · Answer

Just from the photos, it does look like necrosis is happening. I would suggest that you re-visit your doctor today and have all the tape removed and changed to clarify the situation. "Warm" isn't a very good way to assess viability. The dried blood should all be cleaned off to get a look for any signs of pinkness.

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