What Do I Know NOW? Two Surgeries by Two Qualified Surgeons With Bad Results? (photo)

Put my trust in two plastic surgeons that were members of the ASforAPS and Member of ASof PS highly qualified and trained and negative results both times. Most recent one done 5 months ago, I am so depressed and now I dont know who to trust and where to go. I am 53 years old, healthy and did everything I was told to do. My recovery was a nightmare and my dressings werent taken off for for 4 weeks, my stitches came apart twice and he sutured up the whole nipple and mastopexy in his office. (az)

Doctor Answers 6

Nipple Areola Loss

I am so sorry you had a serious complication.  It must have been extremely difficult to go through and must still be.  I am sure you are angry and feel an injustice has been done to you.  As an objective observer, I would like to give you my opinion.  There are clearly cases where malpractice has has been committed. That is, a physician either did something that he should not have,or did not do something that he should have.  Because of this physicians action or inaction a complication occurred.  I don't know if   that was the case with you.  However, I think you should be aware, that in almost all cases where complications occur, whether they be minimal or serious, no malpractice has been committed.  That is, even if a physician did everything correctly  by the book,  complications can still occur.  The reason for this is because we don't, as yet, have a complete understanding of the human body. We may never have that understanding, but we are getting better..  I guarantee you that every surgeon who operates has his or her set of complications.  This is unavoidable.  In your case, I believe you wereactually at increased risk for having the type of complication you had.  This is because you already had implants and you previously had a Benelli lift.  The blood supply to your nipple and areola was already compromised   You subsequently underwent exchange of implants with a full lift.  For whatever reason, there was not enough blood supply to your left nipple/areola complex to preserve its viability.  I am certain that your surgeon did the same surgery on your right breast and, yet, it healed well.  It is unfortunate that this happened to you.  

     I am sure that the overwhelming majority of plastic surgeons, particularly the certified ones are both skilled and ethical.  I know your ability to trust has been affected, but there are surgeons out there that will and can help you.

     With regards to liability and whether you wish to pursue that path, that is a decision that you will need to make.  My thoughts are that If your physician did, indeed, commit malpractice then legal actions are justified.  However, if your physician did everything correctly and despite that this complication occurred, it would be an extreme injustice for legal actions to occur.

Good luck,

Ary Krau MD FACS

Miami Plastic Surgeon
4.8 out of 5 stars 319 reviews

Bad Results

I am truly sorry about what your have endured in the way of complications.

In terms of one or two stages, that is a matter of some controversy, and there are surgeons on both sides of the debate. There is not enough info here to comment much further. For example, this operation was a full anchor lift, but I don't know what the previous lift was. You had implants before, but during this operation was the size increased or the position changed or were the implants removed? Some of the controversy about simultaneous lift and implants involves making a pocket at the same time as the lifting is done, but in this case that may be less of a consideration since the pocket was already made 14 years ago.

You would have to ask your surgeon why there was no dressing change before four weeks. The problem might have been identified earlier, but I am not sure the any intervention might have changed the outcome. 

I don't think too many surgeons looking at the photo of the blackened areola and nipple would have expected a different outcome than what you have had. 

At this point in time, the breasts appear pretty even in volume, and the nipple and areola on the left side are lost. It appears that there may still be a small unhealed area. Once that is resolved and the scars have softened (expect another six months) you may consider having a surgeon reconstruct the nipple and areola.This can often be done with local anesthesia. It will be up to you whether you wish to continue on with your surgeon or seek other opinions in your area.  All the best. 


Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Nipple areolar reconstruction

When the breast pedicles are long, the risk of nipple/areolar slough is greatly increased. Your surgical history isn't complete so it makes it difficult to comment but nipple loss is a known risk of this procedure. I can't comment on why the dressings weren't changed for four weeks. Nipple areolar reconstruction can be performed at the appropriate time to restore the appearance of the breast.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 41 reviews

Complications After Breast Surgery with Board Certified Plastic Surgeons

I am sorry for your experience thus far.  Nipple areola complications can occur with any breast surgery and should be reviewed prior to any breast procedure as a part of the informed consent.  Qualified plastic surgeons have complications. 

What the qualifications provide:

A practitioner that is Certified by the American Board of Plastic Surgery

A practitioner that selects the appropriate patient for surgery

A practitioner that selects the most appropriate surgery for that patient and the issue at hand

A practitioner that has training and experience with the particular procedure and can recognize and treat any complications if they should arise. 

You never detailed the procedure you actually had performed but anytime you operate on a patient that has had breast augmentation and a lift the PS should always be aware of the potential circulation problems that make occur as a result of the operation.

I would wait 6 months to explore possible nipple reconstruction (might not be possible secondary to scar tissue in the area) or a nipple areola prosthesis

Best Wishes


Dr. ES


All is not lost

It sounds like you have had two very unlucky surgeries.  I would recommend letting everything heal and then consulting with a surgeon about nipple reconstruction.  You might be surprised about what is possible.  Good luck.

Sacha Obaid, MD
Dallas Plastic Surgeon
4.8 out of 5 stars 134 reviews

What to Do after Nipple Areolar Necrosis

   You will need careful review of your records and an exam.  There are quite a few options for nipple areolar reconstruction and revision breast lifts.  Kenneth Hughes, MD Los Angeles, CA

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