Transient areolar ischemia occurs as a consequence of all breast lift/reduction procedures. Most commonly, it results in no complications or cosmetic consequences. Prolonged or more moderate ischemia results in cutaneous edema and epidermolysis in approximately 5–11% of patients. Complete full-thickness areolar necrosis has been reported to occur in approximately 0.5–7.3% of all cases of cosmetic, oncologic, or reconstructive breast surgery. Despite this unavoidable fact, there does not appear to be any literature focused on the diagnosis and management of this well-documented complication. We present this paper as a review of the current literature and as a way to establish a standard of management of areolar ischemia and necrosis.
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