About Your Options

Nipple Reconstruction

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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 further operations.
  • 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 crease.

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.

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