Can Areolar Nipple Skin Grafts Get Rejected?

One of the most common questions I hear after nipple graft surgery is: “Can the graft get rejected?” The short answer is that while it is theoretically possible, I have never seen this happen in my patients. Let me explain why healing is usually very reliable and what you can expect during recovery.

How the Graft Works

During surgery, the nipple graft is carefully removed, made smaller, and then placed on its new location. To help it heal, I use a special dressing called a bolster. This acts like a gentle cushion that holds the graft in place and keeps it from moving around. The bolster stays on for about 5 to 7 days.

By that time, tiny new blood vessels have already started to grow between the graft and the skin underneath. Because the graft itself is small, it doesn’t need much to survive—and that gives it a very high chance of healing successfully.

What Healing Looks Like

It’s important to know that healing doesn’t always look pretty at first. The outer layer of the graft often forms a scab, and sometimes that layer of skin peels or sloughs off. This is normal. What matters most is the deeper layer of skin, called the dermis, which is still alive and healing.

You might also notice that the color or pigment of the graft seems lost at first. Don’t worry—this often returns slowly over the next few months as the skin continues to recover.

Caring Reassurance

Healing after nipple graft surgery takes patience, but the process is usually smooth. Your body is remarkable at building new connections and supporting the graft as it settles in its new place. If you notice scabbing or changes in color, know that this is part of the journey. With time, most patients see healthy healing and natural color return.