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4 days post double mastectomy, nipple sparing, direct to implant

gemelsg Member Posts: 3

Good morning/evening and afternoon everyone.

This past Monday I went in for a double mastectomy, which was reconstructed immediately and spared skin and nipple.

While the pain has been tolerable, the drains manageable (but hated!), my left nipple has incurred 2 deep purple spots, both about the size of a dime. One is in the middle of the areola, while one is essentially right onto the nipple stalk, Concerned, I called my surgeon, who said that (in Canada) it's a bit of waiting game. While she believes its venous congestion (which will be reabsorbed by my body), I am just so insanely concerned it's the beginnings of nipple necrosis. I went to see my GP, who pushed on my breast and say color return (after pushing it), which in her mind meant that my bloodflow is there and not restricted. I'm less optimistic and I am hoping people can share their experiences:

* Did you have bruising across the breast (I have all colors - blue, greenish, yellow), with the left one (which also has the purple) being much more pronounced.

* Did you have nipple bruising?

Any and al insight is appreciated. For reference, I am 40F, non-smoker, preventative mastectomy, no health issues,


  • icouldreallyuseacupcake

    Hi G,

    I am also 39, had a nipple/skin sparing BMX with expander placement about three weeks ago. To answer your questions, yes and yes!
    My left nipple was looking horrid within the week after, and I was SURE that I would lose it. It looked nearly black, was oozing, etc. I had mentally written it off. When I got the dressings changed, they told me similar to what they told you, that they could see some blood flow; they went from cautiously optimistic, to optimistic, to now things are looking very good that it will survive. I still have a dressing on it, and there is still a little weeping, but the difference between my check up this week and the previous check ups were night and day. The top layer of skin came off, and it it looking more to its natural color. I also had a nasty patch of skin on the right side that wasn’t getting proper blood, which they put a nitro patch on. Caused a gnarly headache, but that is looking a hundred times better now too. Our bodies have been through so much. Hoping all the best for yourhealing.

  • gemelsg
    gemelsg Member Posts: 3

    thank you so much for sharing your own experience. You mention you saw the first true signs at the 1 week mark. Was it a progression, from purple to black or was it instead rather sudden?

    My area stays purple (if anything, probably turning more reddish then purple) but it’s very obvious that this breast is more swollen and has a lot more fluid still too.

  • icouldreallyuseacupcake

    Hi G- It was more at the 2 week mark that my non-medically trained eyes saw any real difference, and yes, it’s been a slow progression. When the PA and RN told me they saw the blood flow, I thought they were just being optimistic/nice and I was still expecting the worst, but again, it’s looking so much better now I’ve had dressings on it this whole time (including now), so the only times I’ve really seen it were during appointments.

  • gemelsg
    gemelsg Member Posts: 3

    We're 2 days further and still a lot of bruising and swelling.

    For those that did direct to implant (under the muscle), was there a crazy amount of swelling for you as well? How long did the swelling last? My breasts feel so hard and lumpy.

    I went to my GP who said there are no signs of infection, but not being a surgeon, doesn't know what amount of swelling and bruising is normal.

  • DaughterOfBarb
    DaughterOfBarb Member Posts: 29

    I had NSMx last July with TEs placed by my first PS about 2 weeks later. His reasoning was that he felt he got better results by allowing things to heal a bit. My right areola (cancer side) had some delayed healing and turned bright purpleish red followed by brownish grey in the days after my NSMx. I was terrified I’d lose it and my surgeon and PS weren’t super optimistic, but it gradually healed by the time of my TE placement surgery. It did look worse before it looked better (oozing and flaking), but aside from some loss of pigment (it’s not quite as dark as my left areola) and some loss of nipple projection (which was subsequently corrected by a new PS who inserted some tissue during my implant swap), it healed nicely. Brushing and swelling are normal, especially so soon after surgery. Blood flow is good news! It sounds like you are in good hands

  • moderators
    moderators Posts: 8,278

    Hi gemelsg,

    We're just checking in on you to see how you're doing since you last posted -- has your condition improved at all?

    Thinking of you!

    --The Mods

  • beenthere2019
    beenthere2019 Member Posts: 2

    I had the same, double mastectomy with diep flap and immediate reconstruction. I had minimal bruising, drains (also hated!) and no nipple problems. I think you should see your plastic surgeon about your issues. He'd know more than your GP. My plastic surgeon made himself readily available for all questions and concerns.

    My surgery was done Sept. 2019, so all's well so far. No recurrence. I take a hormone blocker and see my doctor every 6 months now. Minimal side effects, and they give me something else to curtail them.

    My advice is to call your Plastic surgeon and have him see it.

    Best of luck to you!