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[dave2009]

I'm due my mastectomy on the NHS early Jan.

Just been for a chat with my surgeon. She says necrosis of the nipple is very rare but can happen.

Just wondered if this happened to anyone and if so, what is the treatment in real terms. I'm usually one of the people who gets the 0.001% chance of going wrong, so just being prepared!!!

Any docs, your help would be appreciated.

Kind regards.

[jsboob]

any surgical procedure carries risks. People die having tooth extractions! ( not many, granted)
 dont let me put you off but also dont let these "pro surgery at any cost" guys here tell you it carries NO risks!

good luck with your op Im sure you will be fine.

[PBC]

   Isn't a mastectomy a much more radical procedure than just a gyne reduction? Is "mastectomy" the word your surgeon used? I thought they were two very different things, but apparently not.

[Dr. Elliot Jacobs]

The medical term "mastectomy" refers to removal of the breast and sometimes skin as well.  Gyne surgery is often called a "subcutaneous mastectomy" in which the tissue removed (the "mastectomy" part) is located subcutaneously, or just under the skin.

Many doctors go through a very extensive list of possible risks and complications prior to surgery.  Some of these risks, such as nipple necrosis are theoretically possible, but so very rare that it is not worth mentioning  unless the patient specifically asks to be told of each and every possible risk/complication or if the anticipated operation is extremely extensive and not a routine type of gyne procedure.

Plastic surgeons are trained to deal with complications should they occur.  It would be best to discuss your own individual operation with your surgeon and since the possibility of nipple necrosis was brought up, then you should discuss the surgeon's plan for treatment if necessary.

Dr Jacobs

[DrBermant]

I'm due my mastectomy on the NHS early Jan.

Just been for a chat with my surgeon. She says necrosis of the nipple is very rare but can happen.

Just wondered if this happened to anyone and if so, what is the treatment in real terms. I'm usually one of the people who gets the 0.001% chance of going wrong, so just being prepared!!!

Any docs, your help would be appreciated.

Kind regards.

Mastectomy is medical speak for breast removal. The nipple gets its blood supply from the surrounding skin and from the gland attached.  Remove the gland and the nipple skin now needs to get its blood from the surrounding skin. Interrupt enough of this second supply and the nipple may die. Nipple skin can also die if traumatized enough such as overuse of cautery or bleeding stopping devices.  The best way to deal with this is prevention.

Surgery like any other activity involves risks. I advise my patients it is like driving a car. If you do not want to get into a car accident, do not drive a car and stay away from where the cars are.  That is not practical, so the next best option is to maximize safety like wear a seat belt. Surgeon selection is an important factor in such issues.  I minimize the risks for my patients by making a smaller incision for most of my surgery, minimizing tissue trauma, special cautery, and other surgical and after techniques. However, such risks are still real and can happen.

Hope this helps,

Michael Bermant, MD
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