Jun
2014

Q&A: How long can I expect the healing process for nipple necrosis?

Ask A Doctor Question: 

How long can I expect the healing process for nipple necrosis. I had a breast reduction. One side healed beautifully, the other developed nipple necrosis. The nipple has been removed and I underwent another surgery to clean it up. Now I have a golf ball size hole from the nipple to the inside of the breast. The Dr. has been seeing it every day, and using gauze and betadine solution to pack the opening. Each time he has seen me since the debridement surgery he has cut out more dead tissue. He assures me it will heal from the inside out. It looks pretty awful to me, thankfully there is no pain, but I'm not sure that is good either. Any suggestions you can tell me would be greatly appreciated.

- Debbie

Answer: 

Haroon Aziz, M.D. - LocateADoc.com

Hi there Ms. Debbie,
 
Nipple necrosis is an infrequent but stressful outcome of breast surgery, especially breast reduction. You have my complete empathy.
 
From your description of your status and treatment that you have received, you are spot on; your treatment is correct and the course/healing that you are going through is slow and pretty much on schedule.
 
When there is necrosis of the nipple, there is also loss of underlying breast tissue. This necrotic (dead) tissue has to be removed/cleaned up/debrided before the wound-open are will heal. Healing takes place by wound shrinkage over several weeks and is from within. The golf ball area will also become smaller.
 
You are on the right track and are receiving excellent care. The frequent debridement is expediting the healing and at this stage is usually done in the office. Based on your description and my experience, you are well on the road to recovery, albeit slow. This will require patience on your part. This can and is stressful and communication with your surgeon is of vital importance. Once again patience is going to be the key factor along with rest and good nutrition.
 
Feel free to ask additional questions.
 
We wish you a speedy recovery.
 
 

--Haroon Aziz, M.D.
Westerville, OH

Answer: 

Barry L Eppley, M.D., D.M.D. - LocateADoc.com

What you have is more than just nipple necrosis but underlying breast tissue necrosis as well. This is a long healing process (3 to 4 months) with early debridement and then allowing the open wound to granulate in. You are still on the front end of this process as the extent of the necrosis is still being determined and removed. The healing part has not yet started. It is typical in necrotic wounds that it will look worse before it starts to get better. It is important to let the entire wound heal in on its own which will be done by the development of granulation tissue and wound contracture. Only then can the issue of what form of nipple reconstruction can be considered. 

--Barry L Eppley, M.D., D.M.D.
Carmel, IN

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