Two weeks after top surgery and the nipple grafts look dark and scabby. Is this normal or are they failing?

Double incision with free nipple grafts, done the last week of September. Bolsters came off at the post-op appointment on Friday and I was not ready for what was underneath.

Both grafts are dark, sort of purple black in places, crusty, and the left one has a patch that looks almost grey. The nurse said "that is all fine" very fast and moved on to the drains and I did not have the nerve to ask more. Now it is Sunday night, I have looked at them in the mirror about forty times, and I have convinced myself they are dying.

Is the dark scabby stage normal? How long did yours take to look like skin? And how would you even know if one had actually failed?

Mine looked like a pair of burnt raisins at two weeks. I mean that lovingly. The top layer came off over the next few weeks in bits and underneath was pink, then slowly normal coloured. Stop looking at them forty times, look at them once a day in good light, and take a photo so you are comparing like with like.

Ollie, I cannot see your grafts and I would not guess at them from a description, so the people to show them to are your own team, and it is entirely fine to ring and ask for a proper look if the conversation on Friday felt rushed. That said, I can explain what the early weeks generally look like, which may help you ask better questions.

A free nipple graft is skin that has been removed and replaced, so for the first days it has no blood supply of its own and survives on what it absorbs from the bed underneath until new vessels grow in. That is why the bolster is there. When it comes off, the surface very commonly looks dark, crusted or patchy, because the top layer of the graft often does not survive while the deeper layer does. That top layer then sheds over the following weeks, and the colour underneath tends to start pink and settle over months. Uneven appearance between the two sides at this stage is common too.

What your team will want to know about, and what is worth a call rather than a wait: increasing pain, spreading redness, heat or swelling around the area, a discharge that smells or looks like pus, a fever or feeling unwell, or an area that becomes soft and breaks down rather than crusting. Partial graft loss does happen and is usually managed with dressings, sometimes with a later touch up, so it is not the end of the world even if it occurs, but it is a conversation for the people who can examine you.

For the wider timeline of the first weeks, drains and the binder included, the site's top surgery recovery guide is a good companion.

Rang them this morning. A different nurse had a proper look over video, said the dark crust is the top layer and the edges are "taking well", and told me to keep up the dressings and come back in a fortnight. None of the warning signs.

Burnt raisins is exactly the right description, Sam.

Saving this for when it is my turn. The once a day photo in the same light is going in my notes.

Five weeks. Most of the crust has come off now and underneath is pink and very obviously alive. The grey patch on the left was crust too. Review on Monday said all on track.

If you are reading this at two weeks at midnight: it gets less alarming. Ring them if you are worried, and then stop looking.