What is Nipple Reconstruction?
Nipple reconstruction is a surgical procedure that involves reconstructing a new nipple or nipple-areola complex areola using surrounding healthy skin tissue after your breast has healed from mastectomy and breast reconstruction. The procedure involves making a star-shaped incision to form a new nipple and then adding a tattoo to shade in the new areola.
Types of Nipple Reconstruction
There are many methods to reconstruct your nipple. Dr Farid will decide on the best possible plan based on the condition of your breast. Some of these methods include:
- Skin Flap Reconstruction: In this method, small skin flaps from your reconstructed breast are folded and stitched together to construct a mound that forms your new nipple. The skin is shaped to accord the nipple an upraised look in comparison to the breast mound. Extra fat, skin, or synthetic fillers may be used to give the nipple a more elevated look.
- Nipple and areola reconstruction: In this method which is also known as Hammond flap larger skin flaps from you reconstructed breast is used to create both nipple and areola complex. creation of the nipple projection is similar to other methods but the line of areola also created at the same operation
- Nipple Sharing/Autologous Graft: In this method, a section of the nipple from your unaffected breast is taken and grafted into your new breast to form a new nipple. This is only done if the nipple from the unaffected breast is large enough to be extracted and grafted.
- Medical Tattooing: An individual may choose to get medical tattooing done after a nipple is reconstructed to achieve a natural-looking nipple and areola. Women who are averse to undergo additional surgery for nipple reconstruction may opt to have only medical tattooing; however, it is important to know that the nipple is not elevated in this situation.
Preparation for Nipple Reconstruction
In general, preparation for nipple reconstruction may involve the following:
- A thorough examination by Dr Meybodi is performed to check if You are a suitable candidate for nipple reconstruction and if your mastectomy flap allows this procedure to be performed.
- Depending on the healthiness and thickness of reconstructed breast skin you might be offered at least one session of Lipofilling or fat grafting. This is to improve and prepare the skin covering your reconstructed breasts for nipple reconstruction.
- You will review photos of patients who underwent nipple reconstruction with different techniques as well as medical tattooing.
- A written consent will be obtained from you after the procedure has been explained in detail.
Before your surgery:
- Refrain from smoking pre- and post-procedure for a specific period of time, as this may hamper proper healing and increase your chances of areolar or nipple damage, tissue necrosis, and other complications.
On the day of surgery:
- You may be instructed to shower with an antibacterial soap in the morning of your surgery.
- The surgery will be performed on the light sedation but it still you better not consume any solids and liquids 8 and 4 hours prior to surgery.
Postoperative Care and Recovery
Most people can go home the same day of surgery if no complications are noted. In general, postoperative care instructions and recovery may involve the following:
- You will have a special dressing to protect your nipple from compression.
- this dressing is also transparent and allows checking off the perfusion of reconstructive nipple
- We will provide you with instructions on bathing and wound care.
- Refrain from using soaps containing harsh chemicals that may irritate your nipple.
- Refrain from any strenuous activities such as aerobics and jogging for at least a week to allow your nipple to heal completely. However, you may resume your normal household activities within a couple of days.
- A periodic follow-up appointment will be scheduled to monitor your overall progress.
Risks and Complications of Nipple Reconstruction
Nipple reconstruction is a relatively safe procedure; however, as with any surgery, the following risks and complications may occur:
- Nipple retraction or flattening
- Tissue breakdown or necrosis
- Changes in nipple appearance