Lisa Hawkins posted about a mother with a thick scar above the areola and a
nipple which is now hard for infant to grasp in spite of efforts with
pumping, etc.  Since the surgery was done to remove ductal tissue, there is
clearly now a cavity where once there was connective and supportive
structure.  While the scar tissue is "above" the areola (at 12 o'clock?)
there was probably tissue removed from under the nipple as well, causing a
collapse.  Some of the erectility is probably just gone from the nipple due
to this.  Also, sometimes scar tissue creates indurations.  If the visible
scar is "thick" ie a keloid condition, I think that can happen internally as
well, creating even more adhesions.  Remember Marianne Neifert's research
which suggests that any kind of breast surgery creates a three-fold risk of
lactation insufficiency.

Options would be to continue as she is with pumping to extract what milk she
can from that side as extra milk for baby, or weaning unilaterally.  This
doesn't sound fixable, although it may be manageable.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html