Hypo-pigmentation/areola depigmentation after surgery

[hypo123]

  I am nearly 3 weeks post-op.  I know it is very early in my recovery but I had some questions.

1 week post op everything looked excellent, perfectly flat and the scars looked like they weren't even going to be noticeable. Minimal bruising, minimal swelling.  After about 10 days I started getting either swelling or scar tissue build-up.  Mostly under my left areola, which is funny because that was the one that was WAY more mild.

This swelling/scar tissue causes my nipple to be slightly puffy (more-so on the bottom around the incision site) which i know is normal and may take months to disappear.  I mention this because it leads into my main concern:

On my left areola (the one that is more swollen/has more scar tissue build up), there seems to be a loss of pigmentation near the bottom of my areola.

The incision site itself (which is still partially scabbed) looks okay, but the area slightly above the incision is a light pink color.  A small patch of it extends almost up to where my nipple is.

I am sure the scar tissue/swelling in that area is stretching the skin a bit and exaggerating the depigmentation, but it is definitely noticeable and definitely there.
 
What could be causing this so early in my recovery?  Everything I read seemed to mention the exact opposite problem: Hyper-pigmentation where the scars were darker than the areola.  From what I read these dark scars would most likely fade to a lighter color but after months or even years.

Why am I having the opposite problem so soon?  I know without pictures it's hard to say, but is this something like the even itself out?  I've been good about not freaking about about swelling and scar tissue but this issue is something I did not expect and has me already googling "areola repigmentation tatoos". 

What should I do?

[Litlriki]

It's tough to say what's going on, but the few patients in whom I've had issues with pigmentation have mostly been hyperpigmentation, as you've mentioned.  I have also had a couple of patients in whom I removed a fairly large mass through a very tiny incision, and the wound edge on the side of the areola got pretty beat up during the surgery.  Two of these lightened, and then eventually returned to normal over many months post-op. 

Based on that, without knowing what went on in your procedure, I would suggest patience--It will likely fix itself.

Rick Silverman

[hypo123]

Thank you for such a quick response!  I should mention that I had excision only.  I'm a pretty fit and in shape guy and never had an issue being overweight.  My gyne was pure glad which I had since puberty.

I'm really hoping these lighter spots fade on their own.  Is there anything I can put on them topically to help speed up the re-pigmentation process?

[Litlriki]

Nothing that I'm aware of.

RS

[DrPensler]

You are still very early.As you are finding out first hand scar is somewhat unpredictable.Patients typically focus on the preoperative size and  feel that smaller should be less swollen.Often at surgery there is more bleeding on one side or additional stitches are required that may alter the postoperative course.At a few weeks sit back and let things settle down.Good luck!