The color of the nipple has changed
In the first days after the operation, the nipple or areola turned blue, darkened or turned pale. This is how a violation of blood circulation is manifested - immediate help is needed.
CONDITION / BREAST
Complications of breast lift and breast reduction.
Complications after a breast lift or reduction are problems that go beyond normal healing: impaired nipple circulation, a split wound, rough scars, asymmetry, areola deformation, or repeated sagging. They are treated even when the operation was performed in another clinic.
CONCEPTUAL VISUALIZATION- What it is
- Problems after a breast lift or reduction that go beyond normal healing.
- Suspender
- In a review of 34 studies (1888 patients), complications after a lift without implants — 10.4%; most often — scars (3%) and nipple and areola problems (2.9%).
- Reduction
- In a meta-analysis of 25 studies of one of the common techniques (1033 patients), the wound diverged in 8%, the nipple and areola died in 1%.
- Who treats it
- A plastic surgeon who performs reconstructive and repeat breast surgeries.
01 / WHAT IS ITWhat is
What is
complications
Breast lift (mastopexy) raises the sagging breast and nipple; breast reduction (reduction mammoplasty) removes part of the gland, fat and skin. After both operations, scars remain: around the areola, vertically downwards, and sometimes also in the fold under the breast.
Part of the change is normal healing. According to the NHS, breast reduction takes 2-6 weeks to fully heal and the scars are red for the first 6 weeks but will mostly fade over time. Nipple sensitivity after breast reduction is only temporarily reduced in most studies, but the quality of these studies is low and the NHS lists loss of nipple sensitivity as a possible complication.
A complication is something that goes beyond these limits: disruption of blood circulation to the nipple, skin or fat to the point of death, a wound that has spread, hard lumps in the breast, rough scars, different shapes of the breast or nipple, skin remnants at the ends of the scars, repeated descent.
If the operation was performed in another clinic, this is not an obstacle: the doctor evaluates what is available now and draws up a treatment plan.
Problems with implants after lifting, together with the increase and restoration of the lost nipple are separate conditions, they have their own pages.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSWhat can
What can
go wrong
Some complications appear in the first days, some - after weeks or months.
The wound spread
The stitches have come apart, the wound gets wet or does not heal for a long time. In a cohort of 290 patients, superficial wound separation after breast reduction was 8.8%.
Difference of seamsSealing
Hard lumps appeared in the chest. According to the NHS, this happens when an area of fat loses its blood supply and dies.
Rough scars
Scars are wide, thick, red, or tighten the skin. In the same cohort of 290 patients, 8.8% had hypertrophic scars.
Hypertrophic scarAsymmetry and areola
Breasts or nipples are different in shape and height, the areola is stretched or deformed, the nipple "looks" in the wrong place.
Deformation of the nipple and areolaRepeated omission
The breasts dropped again, and folds of excess skin remained at the ends of the scars. After lifting together with augmentation, repeated descent in a meta-analysis of 4,856 operations was the most frequent complication — 5.2%.
03 / REASONSWhy do they arise?
Why do they arise?
complications
Part of the risks depends on the person himself, part on the scope of the operation and how it went. Most of the data is about breast reduction.
weight
In a meta-analysis of 61 articles (71,149 patients), a body mass index of 30 or higher was associated with higher odds of complications: delayed healing, fat necrosis, infection, and wound dehiscence.
Smoking and nicotine
Smoking is associated with infection and wound dehiscence. In another study (1,424 patients in each group), dependence on non-tobacco nicotine was also associated with infection and hematoma in the first month.
Diabetes and radiation
Diabetes and past breast radiation are associated with a higher chance of complications; Fat loss, infection, and fluid accumulation are more common after radiation.
Volume of operation
In a cohort of 290 patients, complications were associated with a larger volume of tissue removed and a greater distance from the nipple to the inframammary fold.
Blood supply to the nipple
The nipple is moved on a "leg" made of fabric, through which it is fed. According to the review, knowledge of anatomy, risks and correct technique do not always allow this complication to be avoided.
Time and pregnancy
Breasts also change after surgery. According to the NHS, during pregnancy they can increase again and this can affect the result.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
If the operation was a long time ago and you are concerned about scars, asymmetry or the shape of the breast, this is a planned situation, it usually does not require emergency care. In the first days after the operation, the most important thing is the color of the nipple: if blood circulation has been disturbed, when it was noticed depends on what methods are still left to restore it. If there are no signs listed for 103, first contact the surgeon who operated on you.
103 immediately if:
- it became difficult to breathe or sudden shortness of breath appeared;
- sudden pain in the chest or upper back;
- the heart beats very often;
- the person fainted;
- heavy bleeding from the wound that does not stop;
- confusion or slurred speech;
- very frequent breathing;
- very high or very low temperature, chills or shivering;
- the skin on the body has become bluish, pale or spotted;
- a rash that does not go away when pressed.
When to the surgeon:
Immediately, at any hour: to the surgeon who operated, and if it is not possible to contact, to the reception department, if the nipple or areola turned blue, darkened or turned pale in the first days after the operation; the skin near the seam darkens or turns blue; breasts quickly increase in size, strain and hurt; the pain in the operated breast is strong and increasing. On the same day: the wound is reddened, hot, pus or liquid flows from it, the stitches have come apart, the temperature has risen to 38 °C and above, or one leg hurts and is swollen. Coughing up blood is also a reason to see a doctor the same day. In the coming days: a firm lump has appeared in the breast - see a surgeon to find out what it is. Planned: scars, asymmetry, areola shape, residual skin, re-plumbness—assessed when breasts are stable: in a meta-analysis of one common reduction technique, breast shape was stable after the first year; you can see a doctor even earlier.
05 / DIAGNOSTICSAs defined,
As defined,
what to treat
- Conversation and documents
When, where and what kind of surgery was done, how much tissue was removed, how the first weeks passed; description of the operation, statement and photo before the operation, if any.
- Review
Wound and scars, color, position and sensitivity of the nipple and areola, breast symmetry, compaction.
- Measurements and photos
The position of the nipples and folds under the breast, the difference between the two sides - for a plan and comparison.
- Examination as needed
Ultrasound to assess for fluid compaction or accumulation; tests if there are signs of infection.
06 / TREATMENTHow we treat
How we treat
complications
Treatment depends on what exactly happened and how much time has passed. Acute complications are treated immediately, and shape, scarring, and symmetry are corrected when the tissues have healed.
01
The first days and weeks
Acute complications.
- nipple
- If the nipple's circulation is impaired, treatment depends on when it is noticed and on techniques that restore blood flow. Therefore, it is impossible to delay.
- Wound
- The wound is cleaned, if necessary, a vacuum bandage is applied, and when it is clean, it is sewn up again.
- Dying of tissues
- Dead tissue is removed; a deep defect is closed with local flaps, a graft or a flap with vascular suturing under a microscope.
02
Seals and scars
Weeks and months after surgery.
- Sealing
- In a meta-analysis of 25 studies of one breast reduction technique (1,033 patients), fat loss occurred in 2%. Sealing is evaluated on examination and, if necessary, on ultrasound; what to do with him, the doctor decides after the examination.
- Rough scars
- According to international recommendations, for hypertrophic scars and keloids, the best chance of success is given by a combination of several methods, among them laser. A wide scar can be excised and sewn up in a new way.
- The rest of the skin
- According to the NHS, folds of excess skin around the scars may need to be surgically removed.
03
Nipple and areola
If they partially or completely died.
- Recovery
- According to the examination, if the reconstruction is planned in time and well executed, in most cases the natural appearance of the nipple and areola can be restored.
- What is restored
- The nipple is formed from local tissues, the areola is formed by a medical tattoo.
04
Repeat operation
- Asymmetry and omission
- The shape, symmetry and position of the nipple are corrected by repeated surgery. 10.7% underwent re-operation after a lift along with an increase (data from 13 studies).
- Repeated decrease
- In one clinic, among 7,179 patients who underwent breast reduction, 122 (1.7%) had a repeat reduction; complications or death of fat after it were in 17.2%, death of the nipple — in none. If it is known how the first operation was done, the surgeon can repeat the same "leg" of the nipple - so it is important to have a description of it.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Complications after breast lift and breast reduction are treated at Dr. Valikhnovskyi's Institute of Surgery in the direction of "Mammary gland reconstruction" - in particular, when the first operation was performed in another clinic.
CLINIC SERVICE
Breast reconstruction
Breasts after mastectomy - with own tissues, implants or fat, immediately or later.
View service
What we do for this condition
- Cleaning the wound and dressing — dead tissue is removed, the wound is cleaned and prepared for closure.
- Vacuum therapy — a dressing with negative pressure diverts discharge from the wound and prepares it for closure.
- Patches — a deep defect is closed with local flaps, a transplant, or a microsurgical flap after tissue death.
- Excision of scars — a rough scar is cut out and stitched using another technique; hypertrophic and keloid scars are treated in combination.
- Silicon and fractional laser — scar care from the first weeks and treatment of rough scars.
- Lipofilling — the patient's own fat is injected to smooth the contour and soften the scarred areas.
- Nipple and areola — the nipple is formed from local tissues, the areola is recreated with a medical tattoo.
- Correction of the second breast — if necessary, the second breast is adjusted for symmetry.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend a photo of the breast directly and from the side and, if available, a description of the operation and a discharge from the clinic where the operation was performed.
- ConsultationExamination of the wound, scars, nipple and areola, symmetry; if necessary — ultrasound.
- PlanWhat to treat now, and what to treat after healing, and in what sequence.
- TreatmentDressings, vacuum therapy, flaps, scar excision or re-operation - depending on the complication.
- RecoveryReviews before healing; supportive underwear and load restriction — several weeks.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
After the operation, the nipple turned blue or darkened. What to do?
Immediately, at any hour, contact the surgeon who operated; if it fails, go to the reception department. What methods are still available to restore blood circulation depends on when the blood circulation was noticed.
Is it possible to be treated at your place if the operation was performed in another clinic?
Yes. The doctor assesses what is now and makes a plan. Take a description of the operation, a statement and a photo before the operation, if available.
Scars after breast reduction are thick and red. Is this being fixed?
The first 6 weeks, the scars are red, and over time they mostly fade. If the scar remains thick or wide, according to international recommendations, the best chance is a combination of several methods, including laser; a wide scar can be excised.
The chest dropped again. Is it possible to repeat the lifting?
Yes, the shape and position of the nipple is corrected by repeated surgery. When and how - the doctor will say after the examination; in a meta-analysis of one common reduction technique, breast shape was stable after the first year.
Will nipple sensitivity return?
In most studies, after breast reduction, sensitivity decreased only temporarily, and in a meta-analysis of one of the techniques, it was restored in 6–12 months. But the quality of these studies is low, so it is impossible to predict in advance.
Will I be able to breastfeed after breast reduction?
Maybe, but not for sure. According to a meta-analysis of 33 studies, 62% of women were able to breastfeed after breast reduction, and the odds of not being able to breastfeed were 3.5 times higher than in women without surgery.
A tightness appeared in the chest. Is it dangerous?
After surgery, this happens when the area of fat has died. But any new lump should be shown to the surgeon in the coming days to find out what it is.
Sources
17 sources · systematic reviews, meta-analyses, cohorts, international guidelines and NHSshowCollapse
- Risk factors for complications after reduction mammaplasty: a systematic review and meta-analysisEuropean Journal of Medical Research, 2025doi:10.1186/s40001-025-02723-z ↗
- Risk Factors and Complications in Reduction Mammaplasty: A Systematic Review and Meta-analysisAesthetic Plastic Surgery, 2023doi:10.1007/s00266-023-03387-y ↗
- Evidence-based insights into medial pedicle reduction mammaplasty: A systematic review and meta-analysisJournal of Plastic, Reconstructive & Aesthetic Surgery, 2026doi:10.1016/j.bjps.2026.07.023 ↗
- Vertical reduction mammaplasty utilizing the superomedial pedicle: is it really for everyone?Aesthetic Surgery Journal, 2012doi:10.1177/1090820X12452733 ↗
- Systematic review of outcomes and complications in nonimplant-based mastopexy surgeryJournal of Plastic, Reconstructive & Aesthetic Surgery, 2019doi:10.1016/j.bjps.2018.10.018 ↗
- A systematic review of single-stage augmentation-mastopexyPlastic and Reconstructive Surgery, 2014doi:10.1097/PRS.0000000000000582 ↗
- Management of the Ischemic Nipple-Areola Complex After Breast ReductionClinics in Plastic Surgery, 2016doi:10.1016/j.cps.2015.12.011 ↗
- Managing Necrosis of the Nipple Areolar Complex Following Reduction Mammaplasty and MastopexyClinics in Plastic Surgery, 2016doi:10.1016/j.cps.2015.12.012 ↗
- The Impact of Reduction Mammaplasty on Breast Sensation: A Systematic ReviewAesthetic Surgery Journal, 2023doi:10.1093/asj/sjad234 ↗
- Breastfeeding Ability After Breast Reductions: What does the Literature Tell us in 2023?Aesthetic Plastic Surgery, 2024doi:10.1007/s00266-023-03690-8 ↗
- Secondary reduction mammaplasty techniques and outcomes: Cleveland Clinic experienceJournal of Plastic, Reconstructive & Aesthetic Surgery, 2024doi:10.1016/j.bjps.2024.07.057 ↗
- Nontobacco Nicotine Dependence Is Associated With Increased Early Postoperative Complications Following Reduction MammaplastyAesthetic Surgery Journal, 2025doi:10.1093/asj/sjaf151 ↗
- Updated international clinical recommendations on scar management: part 2--algorithms for scar prevention and treatmentDermatologic Surgery, 2014pubmed.ncbi.nlm.nih.gov/25068544 ↗
- Breast reduction (female)NHS, 2023nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/breast-reduction-female ↗
- Pulmonary embolismNHS, 2026nhs.uk/conditions/pulmonary-embolism ↗
- DVT (deep vein thrombosis)NHS, 2026nhs.uk/conditions/deep-vein-thrombosis-dvt ↗
- SepsisNHS, 2026nhs.uk/conditions/sepsis ↗
The figures on the page are from these sources.
Something went wrong
after breast surgery?
Send a photo of the breast and, if available, a description of the operation. The doctor will tell you what to treat now and what to treat after healing.