What should I do about my bleeding possibly infected nipple? (photos)

Hello I had a bilateral mastectomy 2 weeks ago I noticed after a week bleeding and blacked cracked skin of my right nipple. I have mentioned it to my doc and I was told to put Aquaphor on it a few times a day. I have been doing so and it looks worse. I thought it needs some air But I was told to keep it covered. I feel that half of it is infected do to a very yellow discharge. The other side just bleeds everytime I remove the gauze. What should I do plz help.

Doctor Answers 2

Nipple bleeding

We are all wet on the inside, under the skin, and the top layer of skin over your nipple has sloughed off due to injury. Your nipple will weep serosanguinous (bloody clear liquid) fluid until the nipple skin and or scar heals completely. It is inconvenient but not worrisome. It will probably look fine after it heals. Good luck and take care.

Beverly Hills General Surgeon

Differences between healing changes and infection

Not being able to examine you directly, I believe this looks more like there was some minor, probably unavoidable, tissue injury during the surgery. This is to be expected to some degree in every case. Probably this will heal completely and the skin will regenerate if the bold supply can recuperate and stabilize. Concerns for infection would be if liquid pus flows out, if fever and chills start, or if incisions start to separate/fall apart.After surgery, tissue has to adjust to having changes in the way blood flows in and out of it, additional fluid  injury that makes it swollen, and in some cases, temperature changes and having artificial material adjacent to it. Some times injured tissue dies away before it can be regenerated. If there is too much damage, sometimes it cannot be saved. 
Regenerating tissue can be red and warmer as it calls increased blood flow into itself, it certainly can be painful, and if some of the superficial skin suffers, it can slough and create a raw surface that later heals. So how do we tell these healing changes from infection?Infected tissue gets progressively worse, while healing changes slowly evolve then get better. What some patient think is "pus" is often the body shedding healthy dead cells and "cleaning" itself with infection fighters. Remember when you skinned your knee as a kid and it got sort of "snotty" looking... like toothpaste was on it? and then it dried into a scab? It wasn't "infected", it was the healing process. So, I think there is good news here- keeping the nipple clean and moist with some antibiotic ointment should help it to heal in the next few days/week or so.

Heather Richardson, MD, FACS
Beverly Hills General Surgeon
5.0 out of 5 stars 1 review

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