How do help my areola heal after breast lift? I seem to be losing my areola and nipple on right side. (photos)

Question

I had a breast lift 5 weeks ago. I had breast implants a few years back and my PS and decided to keep the original implants in. After the surgery he told me because he could not cut to deep as not to hit the implant I might have scabing on my areolas. The left breast has healed beautifully but my right one has gone from dark to terrifying. I have spoken to my PS many times about this he says I am having poor circulation and to leave it alone and let the scabs fall of on there own. Help!

York Jay Yates, MD · Answer

Sorry to hear of your complication.  The blood supply to the nipple is inadequate and necrosis has occurred.  The cause of this can be arterial inflow, venous congestion and tension.   This complication occurs more commonly in secondary procedures and in particular in smokers.  At this point there is not much you can do to save the nipple.   I would look to your plastic surgeons advice as to the exact plan from here as I am sure he is just as upset about it as you are.   This would be my recommendation, based on the photo alone:  It looks like the living and dead tissue has demarcated and it is time for a trip to the procedure room for debridement.   The next step would be wound care followed by nipple areolar reconstruction which may include a flap, skin graft or delayed secondary closure.

Carlos Mata, MD, MBA, FACS · Answer

HI Cdoublec,Thanks for your photos and questions. I am sorry about your complication. It certainly is nipple necrosis or just dead skin. Luckily it will heal. It may take some time. It will fall off on its own but the healing process sometimes goes faster when the dead tissue is removed. I would ask your PS to remove the dead tissue to allow your body to heal faster. You will likely need nipple reconstruction but without a physical exam, it would be difficult
to assess exactly what you would need done. You may consider getting another opinion as to treatment options in person.
I recommend being seen by an experienced surgeon.
Good Luck.
All the
best,
Carlos
Mata MD, MBA, FACS

Anthony Deboni, MD · Answer

Thanks for your question and photos. I am sorry that you are having problems. You look to have a significant area of skin/nipple necrosis.  The dark tissue has no blood supply and will eventually slough off.  At this stage, I would recommend that the tissue that is poorly vascularized be removed to allow for better healing; I would not "just leave it." Once the area is allowed to heal, a determination can be made as to if, and what may need to be done to repair/reconstruct the lost tissue.  Keep in close contact with your PS.  Best of luck.

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your
question and provided information as well..
The breasts may lose their elasticity and firmness which can be caused by
different factors such as pregnancy, massive weight loss, lactation and aging.
To reaffirm the breasts and restore the natural look your surgeon can perform a
mastopexy or breast lift. A breast lift restores a firmer, perkier, and more
aesthetically pleasing shape to sagging breasts. This not only can improve
a patient’s appearance by restoring her youthful, feminine proportions,
but also help bras and swimsuits fit more comfortably and attractively. By
removing excess, stretched out skin, reshaping the breast tissue, and raising
the nipple & areola into a more forward position, a cosmetic surgeon can create
a more youthful breast contour. Stretched, large areolae can also be
reduced during breast lift surgery, creating an overall better proportioned,
natural looking breast, Actually the perkiness on a person or another, depends
on patients skin and breast tissue

Keith Denkler, MD · Answer

This will take time to heal, perhaps 3 or 4 more weeks.Then a scar/breast revision will help when the tissues soften.Sorry for your complication.Hang in there.

How do help my areola heal after breast lift? I seem to be losing my areola and nipple on right side. (photos)

Answers (5)

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