Can The Birthmark Next To My Nipple Be Removed?

Q: Dr. Eppley, The birth mark next to my nipple has given me trouble for years. I have been denied by just about every plastic surgeon I’ve been to because they have said the scar is not worth it. I have also had several Sciton IPL treatments that lightened the birthmark but did not completely get rid of it. Please let me know if the skin graft may be a possible answer for my birthmark. Thank you for your time. 

A: Thank you for your inquiry and sending your picture. Your dilemma is that neither excision or a skin graft will produce a marked improvement or elimination of its appearance. Of the two choices, however, excision is the better option as a skin graft will just look like a patch of a different color than the surrounding skin albeit of a lighter color. One excisional option that may not have been presented to you is a staged approach. First cut out the central 2/3s of the birthmark, let it heal for three months and then do a second stage completion excision. This is the best way to reduce the risk of hypertrophic scarring as this allows the surrounding tissues to stretch out in stages as opposed to cutting it out all at once…which has a much higher risk of hypertrophic scarring.

But the reality is that no plastic surgeon probably wants to operate on the birthmark because they fear, and perhaps rightfully so, that unless the resultant scar becomes almost invisible you will be an unhappy patient. That is where the risk of the surgery lies in your case. Your aesthetic requirements, based on the effort you have put into making you body look like it does, makes any scar a high risk proposition.

Dr. Barry Eppley

Indianapolis, Indiana