6 weeks post op, my breast have sunken and flat appearance of the nipples? Is this normal? (photos)

Question

I have silicone, breast implants placed under the muscle six weeks ago with areola incision. They look great with the exception of my right nipple. It looks as though when the doctor stitched it, he stitched too deep into the breast. The skin there doesn't move and has a sunken, flat appearance. It looks worse when I lift my arm. On the left side I can tug on just the skin and move it away from the breast. On the right I cannot. It feels attached. Will this heal in time? If mot how involved will the surgery to "detach" it be? I can't bear the thought of going under the knife again

Paul M. Parker, MD, FACS · Answer

It appears as if your incision is adherent to the deeper tissues--this can happen in the best of hands. Massage can be helpful at this point by releasing that adherence and allowing the nipple to assume a normal appearance. Best to follow up with your surgeon for their assessment and for them to demonstrate to you how to perform the massage if they think that is appropriate.

Jeffrey E. Schreiber, MD, FACS · Answer

It appears as though you're healing well.  However, it's hard to say as I did not do your surgery.  So, see your plastic surgeon if you have any concerns.

Lars Enevoldsen, MD · Answer

Thank you for your question. At six weeks the healing process is at it's peak and this is the time when most scars look their worst.  A photo only tells part of the story and without a physical exam it is impossible to tell what exactly is going on.  In some cases the problem is the scar tissue that has formed from the skin incision down through the breast tissue and muscle to the capsule around the implant  is tethering the scar down, causing the indentation.  In other cases when the surgeon has made an incision through the breast gland  the deep portion of the incision through the gland can stay open causing the skin incision to sink in.  In the first case massage, ultrasound and time may be all that is needed, knowing that you are at that critical 6 week point. In the second case it is not likely to get better with time and will most likely need surgical correction.  As the other answers have said you should see your surgeon and work with him/her to see what can be done.  This is one of the reasons I no longer use the periareolar incision.  It is rare that it happens but when it does it is a real pain to deal with.

William T. Stoeckel, MD · Answer

You are rather accurately described the issue. It appears that the incision closure has resulted in a discontinuity of tissue levels. The good thing is that you are only 6 weeks post op and there is a good chance that the issue will improve. But there is a chance that it will not. The surgery to correct might be quite simple and successful with just local anesthesia. But every once in awhile, scar tissue from this type of issue can be difficult to correct.

Darryl J. Blinski, MD · Answer

Best to have very close follow up with your surgeon to address these issues. Right N/A could use revision in  my opinion.

6 weeks post op, my breast have sunken and flat appearance of the nipples? Is this normal? (photos)

Answers (9)