Summary of Nipple Reconstruction

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Synopsis:

Following a Mastectomy and a breast reconstruction procedure, Six Surgery will often perform Nipple Reconstruction. This procedure will address the size, shape, and positioning of the areola and nipple.

When deciding whether to have nipple reconstruction, there are some issues to consider:
  • The reconstructed nipple will not look like your natural nipple
  • It will not react to temperature or touch by changing size
  • Will not have nerve endings, so you won’t “feel” the nipple’s touch

In addition, some reconstructed nipples appear more or less “perky” than others, depending on the type of breast reconstruction. Because of this some women opt to go without a nipple on their reconstructed breast. This is something that you can discuss with your nurse and surgeon during the SixSurgery consultation process.

Why Nipple
Reconstruction

Following mastectomy for breast cancer, the breast is reconstructed using one of several available procedures. After you are satisfied with the size, shape and symmetry of your reconstruction and you’ve had an opportunity to heal, you may want to consider having nipple reconstruction surgery. Nipple reconstruction is the final stage of breast reconstruction. In some cases, it provides the patient with a sense of well being and confidence.

What is Nipple Reconstruction

If you have reconstruction using skin from another area of your body, skin will be taken from the newly created breast, the opposite nipple, your ear, groin, upper inner thigh or buttocks. A small incision is made in the reconstructed breast as well, so the new nipple can be attached. The surgical technique that causes the least alteration of the shape of the breast is called a skate flap. This involves cutting some of the skin and soft tissue on the reconstructed breast and folding or twisting the skin, then rotating its position to create the nipple.

There are other techniques that include a C-V flap, Arrow flap, Bell flap, which all involve some distortion of the newly created breast mound. Because the nipple is made from a skin donor site, it is the wrong color. To compensate, the nipple is tattooed to match the color of the areola. In addition, a skin graft from a location such as the upper medial thigh or an abdominal scar is used to create the areola. An alternative is to tattoo the areola on the newly constructed breast. Because of color matching, it may require several different tattooing sessions in order to get the color to match.

What to Expect
from Nipple
Reconstruction

When deciding whether to have nipple reconstruction, there are some issues to consider:
  • The reconstructed nipple will not look like your natural nipple
  • It will not react to temperature or touch by changing size
  • Will not have nerve endings, so you won’t “feel” the
    nipple’s touch

In addition, some reconstructed nipples appear more or less “perky” than others. It depends on the type of breast reconstruction, and because of this many women opt to go without a nipple on their reconstructed breast. You can discuss these issues with the SixSurgery team during your consultation.

Are you a Candidate?

Women who’ve had breast reconstruction surgery may be candidates for nipple reconstruction surgery or nipple tattooing

You may not be a candidate if:
  • Your breasts have not fully settled into position post breast reconstruction surgery
  • You’re still healing from radiation treatments damaged your skin
  • Your breast tissue became excessively thinned when skin was removed during the mastectomy

The SixSurgery team usually recommends waiting at least 4 months after breast reconstruction surgery to have nipple reconstruction surgery to ensure your breasts have had time to fully settle.

Steps to Surgery
Consultation

The process begins with an initial consultation with the SixSurgery team. You will have an opportunity to discuss your goals and expectations about the nipple reconstruction procedure with the doctor, and ask any relevant questions you may have.

During your initial consultation, our consultation expert will:
  • Review your medical history and any medications you are taking
  • Discuss the procedure
  • Provide recommendations based on your needs and goals

The SixSurgery team will listen to your needs, expectations and your desired outcome from the nipple reconstruction surgery. You will be able to tour our state-of-the-art surgical facility located in the beautiful Fairmont Royal York Hotel. During this time you will also be able to meet with our caring staff that will be part of your team.

Types of Procedure

  • Using tissue from another part of your body:

    Tissue to rebuild the nipple is taken from your chest wall or from your upper inner thigh.

  • Nipple reconstruction from a dermal product:

    These are skin substitutes made of collagen, like AlloDerm, NeoForm and DermaMatrix.

  • Nipple Tattoo:

    Some women opt to have a nipple tattooed on the reconstructed breast. There are dermabrasion nipple tattoos that use a high frequency vibrating probe to push pigment into the skin. These tattoos tend to fade over time. Another is 3-D tattoos, which are permanent and do not fade.

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