Keloid scars can occur on the nipple after surgical procedures, nipple piercings, and other things that may cause an injury to the nipple. Hypertrophic scars are scars that are bumpy and prominent, but don’t overgrow the original site of injury. Keloid scars, however, grow outside the original boundaries.
This is an example of a keloid scar after a nipple eversion procedure and a subsequent nipple piercing. Unfortunately, the size of this keloid will preclude breastfeeding from that breast. The nipple eversion procedure has also obliterated ductal orifices. Prenatally, colostrum is expressible from her right nipple but not her left.
This patient was able to breastfeed exclusively from her right breast. She used ice and pain medication to reduce engorgement from the left breast, but it actually leaked milk and this also helped relieve her. The baby was not able to latch due to lack of brisk flow and size of the scarring, but she used a milk collector to save leaking milk (middle photo).
Left areola keloid at site of irritated Montgomery gland. This was biopsied due to no overt trauma/injury history and the overall regularity (keloids traditionally are less smooth and symmetric in appearance).
