Pain and Hardness After Nipple Reconstruction Surgery

Nipple inversion correction surgery

Hello Doctor, I underwent nipple inversion reconstruction surgery at the beginning of January.
However, about three months post-surgery, I started experiencing pain around the nipple area along with the presence of a hard lump.
During my follow-up visit, the doctor mentioned that it might be related to the sutures and suggested further monitoring (although he had previously stated that the type of sutures used were absorbable).
An ultrasound was performed, but no issues were identified, and the responses I received were quite uncertain.
Now, approximately six months later, the pain and hard lump persist, and I have even woken up in the middle of the night due to the pain.
Could you please advise what this condition might be?

Nini, 20~29 year old female. Ask Date: 2019/07/04

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I recommend that you consult a breast surgeon for a more appropriate evaluation.
Wishing you good health.

Reply Date: 2019/07/04

More Info

After undergoing nipple reconstruction surgery, experiencing pain and hardness around the nipple area several months post-operation can be concerning. It’s important to understand that while some discomfort can be expected after any surgical procedure, persistent pain and the presence of hard lumps may indicate underlying issues that need to be addressed.

Firstly, it is not uncommon for patients to experience some degree of pain and hardness around the surgical site for a few weeks following surgery. This can be attributed to the healing process, which involves inflammation and the formation of scar tissue. However, if these symptoms persist beyond the typical recovery period, it may warrant further investigation.

The pain you are experiencing, especially if it disrupts your sleep, could be due to several factors:
1. Scar Tissue Formation: After surgery, the body forms scar tissue as part of the healing process. This tissue can sometimes become thickened or fibrous, leading to a sensation of hardness and discomfort. If the scar tissue is extensive, it may also cause tightness or pulling sensations around the nipple.

2. Nerve Sensitivity: Surgical procedures can sometimes lead to nerve irritation or damage. This can result in heightened sensitivity or pain in the area, which may feel like sharp or shooting pain. If the nerves are involved, this could explain the pain that wakes you from sleep.

3. Absorbable Sutures: While your surgeon mentioned that the sutures used were absorbable, it is possible that remnants of these sutures could be causing irritation. Sometimes, even absorbable sutures can lead to localized inflammation if they do not dissolve properly or if they provoke a foreign body reaction.

4. Infection or Seroma: Although less common, persistent pain and hardness could indicate an infection or the presence of a seroma (a pocket of fluid that can develop after surgery). An ultrasound may not always detect these issues, especially if they are small or if the infection is localized.

5. Other Complications: In rare cases, complications such as fat necrosis (death of fat tissue) or issues related to the blood supply to the nipple can occur, leading to pain and hardness.

Given that your symptoms have persisted for about six months, it is crucial to follow up with your surgeon or a specialist in breast surgery. They may recommend further imaging studies, such as an MRI, to get a more detailed view of the tissue and assess for any complications that may not have been visible on the ultrasound. Additionally, they might consider a physical examination to evaluate the area for any signs of infection or abnormal tissue.

In the meantime, managing pain with over-the-counter pain relievers, applying warm compresses, and avoiding activities that exacerbate the pain may provide some relief. However, these measures should not replace professional medical advice.

In conclusion, while some discomfort is expected after nipple reconstruction surgery, persistent pain and hardness should be evaluated by a healthcare professional to rule out any complications and to ensure proper healing. Open communication with your surgeon about your symptoms is essential for your recovery and peace of mind.

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