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

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

Doctor Answers 10

Scar

It is unlikely that the doctor sutured the tissue too deeply.  The mostly likely cause of this is that your body is trying to minimize scars (which extend all the way through your breast from the skin) by contraction.  I would recommend massaging this scar several times a day to "free it up" from the deeper tissue.  It should settle down, but if it hasn't after many months, it would be a simple procedure to perform a revision of this area.  I hope this helps, regards.


Melbourne Plastic Surgeon
5.0 out of 5 stars 36 reviews

Appearance of breasts after augmentation

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.

Periareolar scar retraction

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.

Lars Enevoldsen, MD
Modesto Plastic Surgeon
4.7 out of 5 stars 22 reviews

Areola retraction

Sometimes with swelling an areola incision can appear slightly retracted.  At this point you need to give it time to heal and allow for the swelling to subside.  Massage may help.  A revision may be necessary in the future.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Retracted periareolar breast implant incision

Thank you for your question.  You are correct that there is retraction of the trans-areola scar on your right breast following your augmentation.  This is due to the fact that the undersurface of your incision is adherent to the underlying scar tissue caused by your procedure.

Please see your plastic surgeon and ask if deep massage may help release the scar contracture.  In addition I half found 1540 non-ablative fractional erbium laser treatments to be helpful to improve this type of scar.  For more information on laser scar treatment please read the following link:

Periareolar incision problems

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.  

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 80 reviews

Nipple problem after breast enlargement

Thank you for your breast implant question.

  • The indentation reflects a small suture that will dissolve.
  • The nipple will flatten out in time -
  • Time means up to 6 months.
  • Be patient and all will be well -- Best wishes.

Too early to worry

At 6 weeks you have a lot of heling to do.  You likely will be fine.  I have seen the problem you address and it likely will go away but occasionally it persists.  The surgery to correct it is easy and successful and simple.  My Best,  Dr C

6 weeks after breast augmentation

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.

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

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

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.