Areola Tissue Damage After Breast Reduction Surgery

This case involves a female patient who underwent a breast reduction surgery and developed an infection, which led to necrosis and death of the areola tissue. The patient underwent several additional surgeries to reconstruct a nipple that was met with little to no success. There were several signs of an infection following the surgery, which the patient alleged the physician failed to adequately monitor. The patient developed a debilitating cardiac infection following the surgery. The patient alleged that this infection may be attributed to the infection she had developed in her breast.

Question(s) For Expert Witness

1. Is this an accepted complication of the procedure?

Expert Witness Response E-004899

As with any type of reduction or mastopexy procedure, the most worrisome complication of this operation is partial or complete nipple-areolar necrosis. To prevent this complication, the viability of the nipple-areola complex (NAC) is evaluated closely following its inset at its new position and also at the end of the surgery. The viability is best evaluated by the presence of good quality bleeding (ie, slow bright red ooze). Temporary loss of sensation to the NAC is a more common complication. Patients commonly experience dysesthesias after the surgery, but sensation returns to normal after a few days or months. Permanent loss of NAC sensation is extremely rare. Partial or complete flap necrosis is a potential but rare complication with this operation.