Necrosis is a medical term used to describe tissue death, so the thought of experiencing it after a breast lift is terrifying. Fortunately, tissue necrosis in the breasts isn’t anywhere near as bad as it sounds. Potentially occurring almost anywhere in the body, necrosis happens when the blood supply to certain cells gets disrupted or compromised. The resulting lack of blood causes the cells to die. This usually occurs as a result of trauma such as an injury or surgical procedure. It’s both a common and fixable problem, and it has no impact on your likelihood of developing breast cancer.
How Common is Necrosis After a Breast Lift?
Of all the tissues in the body, fatty tissue is the most likely to suffer from necrosis. The breasts are the largest collection of fatty tissue in the body and therefore are the most common location for necrosis. Breast tissue necrosis is quite common, occurring in 4 to 25% of women who undergo breast surgeries. This includes all breast surgeries, including breast lift, breast reduction, mastectomy, and lumpectomy.
Signs of Necrosis After a Breast Lift
If tissue necrosis begins shortly after your breast lift, you may notice yellowish fluid leaking from your incision. Necrosis can occur months or even years after surgery, however, so your incision could be long since healed. When it happens near the surface of your skin, necrosis can change the skin’s appearance, creating patches of red, thick, and bruised skin with a different texture from the surrounding area. Your skin might look dimpled, and your nipple could be pulled inward. Necrosis can also happen more deeply in the breast, creating hard lumps and bumps.
What Does Necrotic Tissue Feel Like?
Early on necrosis may feel like a lump of squishy fat within the breast. Over time, this lump typically hardens into a more rigid lump or nodule. Necrosis can also simply feel like parts of your skin have a different texture. The condition usually doesn’t hurt, although it can cause some soreness or tenderness.
How is Necrotic Tissue Diagnosed?
After a breast lift, your doctor may be able to confirm a suspected case of necrosis through a physical examination. He may also perform a mammogram, MRI, or ultrasound to get an image of your breast.
Another option is to gather some of the cells and examine them directly. When done via fine needle aspiration, your doctor inserts a small needle into the suspected necrosis and draws out some cells. He will then look at these cells under a microscope to determine if they are necrotic. If he wants to look at a larger sample, he will opt for a core biopsy instead. This involves inserting a hollow needle into the potentially necrotic area and removing a larger sample of tissue for examination.
How is Necrosis Treated?
Sometimes doctors treat post-breast lift necrosis by doing nothing at all. If the necrosis isn’t causing you any discomfort or creating a misshapen appearance to the breast, your surgeon may allow the condition to resolve on its own. Eventually, your body will absorb the dead cells and they will go away. If the necrosis is causing you pain or other issues, however, your doctor can surgically remove it. This typically occurs via excision biopsy, where local anesthesia is administered, a small incision is made in the skin, and the necrotic tissue is removed. This procedure is sometimes performed with the assistance of a vacuum to help draw the necrotic area out more easily.
Most doctors try to avoid removing necrosis through more complex surgeries since surgery itself can cause necrosis. Sometimes, however, the necrotic area is too large to remove through a needle. In this case, surgical excision under general anesthesia may prove necessary.
How to Prevent Necrosis After a Breast Lift
Unfortunately, there isn’t much you can do to prevent necrosis after a breast lift. It’s known that cigarette smoke interferes with the healing process, so you can help yourself if you quit smoking prior to your surgery. You should also choose a qualified, experienced plastic surgeon for your breast lift procedure who understands and employs the latest techniques for preserving blood supply. There is never any guarantee that necrosis won’t develop, however, even when working with a top-notch surgeon.
Nipple Necrosis After a Breast Lift
Happily, necrosis of the nipple after a breast lift is a very rare complication. This is because, during a breast lift, most surgeons leave the nipple and areola attached to a stalk of tissue called a pedicle. This preserves blood flow to this sensitive area throughout breast reduction or lift surgery. Nipple necrosis can happen, however, and its treatment is slightly different.
In mild cases, the necrotic tissue is removed from the nipple and it is allowed to heal. When the necrosis is more extreme, your doctor may need to remove your nipple. If so, he may be able to surgically reconstruct a new nipple for you. If not, a medical tattoo artist can give you a very realistic, three-dimensional-looking nipple tattoo to normalize the appearance of your breasts, if desired.
Is It an Infection or Necrosis? The Differences and Similarities
Because both can cause a yellowish discharge from your incision as well as redness, infections and tissue necrosis are sometimes confused. An infection, however, is often accompanied by a fever and may cause the skin around the infected area to feel warm to the touch. Necrosis doesn’t cause fevers or warm skin. Antibiotics will treat an infection, but there is no reversing necrosis. Once tissue has died, removing it or allowing the body to reabsorb it are the only options.