Nipple and Areola Reconstruction

In addition to reforming the breast after breast cancer surgery, some women want to reconstruct their nipple. It is important to note that a reconstructed nipple won’t function like a natural nipple; so many women elect to go without a reconstructed nipple.

Nipple reconstruction surgery usually takes place three to four months after breast reconstruction surgery to give the new breast time to heal. Nipple reconstruction surgery is usually done as outpatient surgery.

Types of Nipple and Areola Reconstruction

There are several procedures available to restructure the nipple and areola after a mastectomy that provide good results. The main challenge in nipple reconstruction is to create a three-dimensional structure.

• Skin flap reconstruction: Small flaps of skin around the nipple area are folded and sewn together to create a bump.
• Skin graft reconstruction: A small piece of skin from a different part of the body is used to create the areola and possible nipple.
• Medical tattooing: Nipple reconstruction is often combined with tattooing to simulate areolar and camouflage scarring. However, some women just have nipple reconstruction or just have tattooing without the other. There have been recent improvements in nipple tattoo techniques, including 3D tattooing that uses shadow to create the appearance of a raised nipple.

Recovery is relatively fast but keeping the nipple clean and dry is important. During healing, the nipple may be tender and appear more erect than usual.

Advantages of Nipple and Areola Reconstruction

• Can be done as an outpatient procedure
• You can decide later after breast reconstruction if you want to have nipple reconstruction
• Aesthetically completes the look of the breast to help with confidence and body image

Disadvantages of Nipple and Areola Reconstruction

• Doesn’t react to temperature or touch by flattening and becoming larger
• Will not have feeling
• May appear more or less “perky”
• Flaps and grafts may flatten over time, needing repair
• Tattoos may need to be retouched every few years

Risks and Side Effects of Nipple and Areola Reconstruction

Though relatively mild, you may experience side effects like bleeding, pain, swelling, infection and fatigue. To avoid complications, follow the care instructions you’re given by your doctor and contact your health care team if you experience any issues.

Risks from nipple and areola reconstruction may include:

• Nipple flattening or retracting
• Loss of sensation in the breast
• Changes in the appearance or sensation of the scar
• Necrosis, or tissue breakdown

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