Nipple Areola Necrosis? (photo)

I wanted to get feed back as to if It looks like its healing properly, I put the silverdene on it everymorning what changes will I expect? When If fully heals how will it look? I had my surgery on november 13, 2012 and I dont know what to look for or to expect. Please Help Geminit

Doctor Answers 10

Necrotic nipple needs debridement

Although I agree with the doctors below that your wound will heal with current treatment I would recommend a surgical debridement. There is a significant amount of necrotic (dead) tissue which must be removed. Once the dead material is gone your body will be able to heal your open wound quickly and allow you to proceed with the nipple reconstruction you will require.     

Los Angeles Plastic Surgeon
3.1 out of 5 stars 10 reviews

Nipple/Areola Necrosis after Breast Reduction?

I'm sorry to see/hear about the complication you have experienced after breast reduction surgery. As you know, it will likely require several more weeks of dressing changes and minor debridement procedures before the wound has completely healed. As time goes on, you will notice that the tissues will look healthier ( with more red tissue and less yellow/brown tissue).

In the longer term, you may benefit from the nipple/areola reconstructive procedures. Patience will definitely be  necessary;  sometimes multiple “smaller” procedures are necessary to achieve the desired outcome.

Continue to follow-up with your plastic surgeon. Best wishes for a long-term outcome that you will be pleased with.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,485 reviews

Fat necrosis and loss of the areola can happen with breast reduction.

The picture demonstrates a significant wound with loss of the areola and fat necrosis. Healing will take a number of weeks because of the poor blood supply to the fat in the breast. Attentive wound care will be necessary for good result. The areola will probably have to be reconstructed secondarily.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Nipple areola necrosis after reduction

You do have some necrosis which may require more debidement.  I am sure you are being monitored by your doctor.  This will heal with a bit more time.  A small scar will result and then you can get reconstrucions of your nipple areola complex on both sides.  It will be a multiple month process.

Talmage Raine MD FACS

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon
4.6 out of 5 stars 9 reviews

Postoperative Care and Reconstruction of Nipple-Areolar Necrosis

It will takes several more weeks of topical wound care until the eschar comes off from your near complete nipple-areolar necrosis. Once you get a good bed of granulation tissue, you will need to consider a skin graft to expedite the healing. Nipple-areolar tattooing can then be done 3 to 6 months later.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Nipple areola necrosis after breast reduction

This is a rare but problematic complication of breast reduction surgery.

With time skin will grow over the defect and things will look much better than what they do now. However it looks like you may have lost most of the nipple - you will have to wait for a few months to find out how that settles.

Currently all you can do is keep the wounds clean. Occasionally if there is some dead tissue that does not separate easily, your surgeon may have to remove that surgically as a minor procedure - that can speed up the healing process.

Good luck and post some more photos afterwards if it does not settle very well.


Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon
4.8 out of 5 stars 32 reviews


You need to be seen by your PS and hopefully weekly right now to evaluate and treat the tissue that appears to not be alive. The process will take a while, but there is no way to predict cosmetic outcome. There are methods to reconstruct the nipple and areola.

Michael Hueneke, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 63 reviews

Nipple Areola Necrosis and Debridement after Breast Reduction

    The nipple areola necrosis you have should be examined to determine if anything further needs to be debrided.  At this point, the area will need to heal.  Then a revision can be contemplated after healing is complete.  You may be able to get to the result you seek, but it will take a little longer.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Nipple Areolar Necrosis

Dear Geminit

I am sorry for your complication after your breast reduction.  It appears that you have a full thickness loss of the nipple, and most of the areola.  More than likely when this fully heals, you will require a revision in order to improve the shape and look of it.  I would contact and be evaluated by your plastic surgeon to see if any more excision of tissue is required in order to improve the healing of the area.

Good luck in your endeavors

Robert Kratschmer, MD

Robert Kratschmer, MD
Houston Plastic Surgeon
4.5 out of 5 stars 36 reviews

Nipple & Areola Necrosis

It appears that have have near total loss of the nipple and areola.  Did this happen on both sides or just one - it is hard to tell from the pictures.  In either case, you need to follow closely with your plastic surgeon with aggressive wound care.  Eventually, you may need a skin graft and tattooing to help reconstruct your nipple & areola complex. 

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

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.