Skip to main content

Nipple Reconstruction


Recreating the nipple areola is the final component to making your breast reconstruction complete. There have been numerous approaches to nipple reconstruction over the last 30 years, and with several options available, surgeons can utilize whichever method is most suitable for their patients. There is no one absolute best method of nipple reconstruction for all patients. Some patients are comfortable without having a nipple, and do not wish to have further surgery. Others choose the non-surgical option of tattooing without reconstruction. This allows color pigmentation to simulate the nipple areola without the contour of an actual nipple. Still, the reconstruction of the nipple areola helps to put the finishing touches on the new breast after a long journey in reconstruction.
After optimal symmetry between the breasts has been achieved, the nipple areola reconstruction can be done. There are a number of factors 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. Even more important, is your surgeon’s preference.
Historically, one technique included sharing a piece of the nipple from the opposite breast. This surgery is not used today, because it transfers breast tissue to the reconstruction that could potentially form a new cancer. Another method used in the past involved taking a full thickness skin graft from the labia to create a dark colored areola. This outdated technique leaves a scar in an undesirable location. Also, these grafts may be hair bearing, and areolar pigment is easier achieved with medical tattooing.
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.

Nipple Areola Reconstruction (Skate Flaps and Skin Graft)

Nipple Areola Reconstruction



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. Alloderm has also been utilized by some surgeons at the time of nipple reconstruction to maximize projection and correct flattening.
Nipple reconstruction is 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, you will have the tattooing done in your surgeon's office. 

Comments

Popular posts from this blog

"Hard nipples" - areola or nipple skin

Someone once wrote"... when i get really cold, or get goosebumbs all over my body, the whole things really scrunch up, like, my entire areola scrunches itself up into a wrinkled little mound. it looks really weird and ugly, and i haven't ever seen other people's breasts do it. what is wrong with my areola/nipples??" The answer: Well nothing is wrong. This is what my areola does too. It's a normal reaction to the coldness or to irritation / stimulation. The little muscles in the areola do a similar goosebump thing as your other skin can do. People often call this phenomenon "hard nipples". Also note that skin on areola has less feeling or sensation to it than other areas of your body. If the areola was very sensitive, then breastfeeding would probably be quite uncomfortable because the baby pulls and tugs it! The nipples are sensitive but the sensitivity changes with hormonal changes, such as occur at mestrual cycle or pregnancy. Also this v...

Kate Jackson Breast Cancer a flash back

THE MOST MOMENTOUS CHANGE IN Kate Jackson's life began early one morning in January 1987, during her fourth season on the hit TV series Scarecrow and Mrs. King. After a phone call informed her that the show's taping was canceled because costar Bruce Boxleitner had the flu, Jackson went back to sleep. When she woke several hours later, "It was out of the blue, but perfectly clear," she recalls. "I sat up in bed and literally said, 'You have to have a mammogram.' " She did, and two days later a biopsy confirmed her vague fears: A minute growth found in her left breast was determined to be malignant. "I was forced to face, squared up, my own mortality," says Jackson. "I had to decide whether I wanted to live or to die. And if you choose life, as I did, it's never the same." For three TV seasons 16 years ago, she was famous as Sabrina Duncan, a girl-next-door gone glamorous and the character critics dubbed the brainiest o...

The four stages of breast development

In Stage 1 shows the flat breasts of childhood. By Stage 2, breast buds are formed as milk ducts and fat tissue develop. In Stage 3, the breast become round and full, and the areola darkens. Stage 4 shows fully mature breasts. (Illustration by GGS Information Services.) period begins. Usually these signs are accompanied by the appearance of pubic hair and hair under the arms. Once ovulation and  menstruation  begin, the maturing of the breasts begins with the formation of secretory glands at the end of the milk ducts. The breasts and duct system continue to grow and mature with the development of many glands and lobules. The rate at which breasts grow varies significantly and is different for each young woman. Breast development occurs in five stages: Stage One: In preadolescence, the breasts are flat and only the tip of the nipple is raised. Stage Two: Buds appear, breast and nipple are raised, fat tissue begins to form and the areola (dark area of skin that ...