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SAINT LOUIS BREAST RECONSTRUCTION: NIPPLE RECONSTRUCTION

What is a nipple reconstruction? The nipple is the natural bump found on the breast. The areola is the pigmented circle that surrounds the nipple. It is usually a pink color in Caucasian people and is brown colored in Asian and African-American persons. The nipple is usually removed with a mastectomy unless a nipple-sparing mastectomy can be performed.

The nipple is usually reconstructed using an operation called a CV flap, skate flap or double-opposing tab flap. Basically, a specific pattern of skin and fat is raised on the breast in the area where the surgeon wishes to place the nipple. These flaps of skin are rearranged to form a projecting nipple shape. Six to 8 weeks later, a tattoo is used to color in the areola. This also effectively camouflages the scar that was used to make the nipple. Skin from the labia or groin can be used instead of a tattoo to reconstruct the areola (the pigmented circular area that surrounds the nipple).

Alternative forms of nipple reconstruction include grafting part of the nipple from the other breast, placing a piece of ear cartilage, or using a filler material such as fat. All these can be employed to reconstruct the nipple or add projection to a previously reconstructed nipple that has flattened over time.

Anesthesia: Nipple reconstructions are usually performed with the patient under local anesthesia but may be combined with other procedures when the patient is under general anesthesia.

Length of procedure: 30 minutes for one nipple, 60 minutes for two nipples. Tatooing takes 30-45 minutes.

Estimated recovery time: Sutures are removed at 10-14 days. A protective dressing is worn for 2 to 4 weeks. Normal activity except for vigorous exercise or heavy manual labor can resume in about 48 hours. To learn how to prepare for a nipple reconstruction and what to expect afterwards, click here to download our patient instructions for nipple reconstruction.

Side effects: Common initial side effects include bruising and swelling. Nipples tend to lose their bulk and projection over time so they are intentionally oversized to begin with to compensate for this. Delayed wound healing and infections may occur. Click here to download a detailed consent form from the American Society of Plastic Surgeons that lists the risks and benefits of nipple reconstruction.

Before-and-after photos of nipple reconstructions: Click here