Nipple Reconstruction

Many people have asked about what happens with the nipple and areola after the reconstruction. I do have a post on nipple-sparing mastectomy. However, if the nipple-areolar complex (NAC) is removed during the mastectomy, there are several different procedures to reconstruct the NAC to complete the breast reconstruction. I usually wait approximately 6-12 weeks after the implants are placed in order to allow the swelling to subside as well as to allow the implants to settle into their formed pockets.

There are several techniques to reconstruct a nipple. All are very effective, and basically comes down to surgeon preference. The main goal of the nipple reconstruction is to provide the appearance of a nipple as well as give the projection of the nipple. It is a very simple procedure, which usually is performed under local anesthesia alone, often times in the office in less than an hour. Downtime is minimal and local care to the incisions is all that is needed. The biggest problem with nipple reconstruction is loss of projection, usually quoted as about a 30-6-% shrinkage from immediate postoperative appearance. Various things surgeons have tried are to add a filler (e.g., fat, dermis, cartilage, or other material), in order to support the nipple and decrease the amount of postoperative shrinkage. Overall, is is a very safe and easy procedure; most women in my practice opt to undergo NAC reconstruction, as it truly "finishes" the breast reconstruction.

After these incisions are completely healed, there are various techniques to reconstruct the areola, including tattoos and skin grafts. This will be discussed next.