Is it True That If You Get A Second Breast Reduction, Your Nipples Turn Black and Fall Off?

I live in Canada and the jugs r so big I hate a braw the straps dif in ... I have dents in my shoulders ... I had my first one like 23 yrs ago and and today they are bigger then I had issues with them before so much pain.... Went to surgeon he told me that 97% chance that with my second breast reduction because the procedure involves cutting into nerves around the nipple a different way they use it true can the tissue die turn black and fall off.... Is there ani Other way?

Doctor Answers 4

No your nipples will not turn black and fall off

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Getting a second breast reduction is normal (not very common but normal) and it does not lead to nipples falling off.  Poor planning and blood supply make nipples fall off.

Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Nipple circulation can be affected by the second reduction mammoplasty but risks can be minimized

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Hi, As a surgeon that has done thousand of breast reductions over the last 18+ years, I understand your plight.  Just this past week I did three such cases.  It is not that unusual for patients to present with large breasts, years after their initial reduction mammoplasty, requesting a second reduction.  Your surgeon is right to impress upon you that there is a slightly higher risk of vascuilar injury to the nipples / areolas with the second operation.  Most certainly your surgeon knows what technique was used for your initial operation and can minimize your risk but adjusting his technique in such a way as to decrease the risk of injury to the circulation to the nipple and areola.  That said, if the quote was really a 97% risk of circulation problems, seek a second opinion.  Alternatively, if he said that there is a 97% chance that you would lose your sensation in the nipple, that does not affect the circulation and does not affect the viability of the nipple.  I'm sure he advised you to avoid smoking and second hand smoke.  This can severely affect the blood supply to your nipples.  Hopefully it all works out and you neck and back pain are resolved soon.  Dr. Scott Barr

Scott Barr, MD
Sudbury Plastic Surgeon

Black Nipples after Repeat Breast Reduction?

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Thank you for the question.

Your  experience is not that unusual.  You may be a candidate for repeat breast reduction surgery.  

If you do decide to undergo repeat breast reduction surgery,  it will be very helpful to your plastic surgeon (if at all possible),  to review the previous operative report. The concern with repeat breast reduction surgery is related to blood flow to the remaining tissue;  if too much tissue is removed in one operation the blood flow to the remaining tissue (including nipple/areola)  may be compromised.   Part of the tissue that is left in place is called the “pedicle"; this segment of tissue is responsible for delivering the blood supply to the nipple/areola tissue.   Must be taken during repeat breast reduction surgery to avoid cutting the  pedicle that is responsible for “delivering” blood flow to the nipple/areola complexes.  If this does occur,  tissue necrosis may result.

I hope this helps.


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It is possible that a secondary breast reduction may jeopardize the nipple. Your surgeon needs to know how the first procedure was done technically speaking. Depending on the method, he should be able to reduce the risk of nipple necrosis by determine the blood flow pattern. I have done this many times but it needs to be done with caution and attention to your past history and meticulous technique.


Robin T.W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

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.