About Your Options
Creating the nipple areola is the final component of your breast reconstruction
There is not one absolute best method of nipple reconstruction suitable for all
patients and you should work with your surgeon to find the best option for you.
- Some patients are comfortable without having a nipple, and do not wish to have any
- Others choose the non-surgical option of tattooing without reconstruction. This
allows colour pigmentation to simulate the nipple areola without the contour of
an actual nipple.
- However, some others consider the reconstruction of the nipple areola the finishing
touch on the new breast after a long journey in reconstruction.
There are a number of considerations that help determine which method of nipple
reconstruction is right for you.
These include the quality of tissue on the reconstructed breast and whether you
are having nipple reconstruction with or without a surrounding graft. Your surgeon’s
preference is also important.
In modern approaches to nipple reconstruction, the nipple mound is created from
skin taken as a local flap on the reconstructed breast.
Various local flaps have been described, including the Skate flap, the C-V flap
and the Star flap. Regardless of which approach your surgeon chooses, the outcome
will be a nipple mound. The areola can then be either tattooed, or it can be reconstructed
with a skin graft taken from elsewhere on the body. Common donor sites for the graft
include the abdominal scar from a flap reconstruction, the inner thigh, or the buttock
All nipple reconstructions lose some projection over time as part of the normal
wound healing process. The risk of wound complications in nipple reconstruction
is very low in patients with no history of prior radiation but common in the radiated
breast. In the case of failed nipple reconstruction, it may be necessary to revise
the reconstruction with another local skin flap. Sometimes, the use of dermis or
fat grafts and fillers such as Radiesse may be necessary to improve nipple projection.
Nipple reconstruction is typically done as an outpatient, ambulatory procedure.
The rate of recovery depends on what other revisions are done simultaneously, and
where the donor site for the areola graft is located. Once you have healed, if you
choose to, you will have the tattooing done in your surgeon's office.