Women have the option to undergo nipple reconstruction or restoration after they have had a mastectomy. Often women desire a reconstruction of the nipple because it offers a sense of completeness after breast reconstruction surgery, even though nipples created by a plastic surgeon do not have the same sensation or react as natural nipples. Fortunately, nipple reconstruction is done 3-4 months after surgery to allow the breast to heal, and women have the option to wait longer if need be.
What is Nipple Reconstruction?
Nipple reconstruction is a plastic surgeon’s attempt at recreating the darker-colored areola and the elevated nipple. It is the optional and final phase of breast reconstruction surgery. Several approaches can be utilized to reconstruct your nipple depending on your preferences and the condition of your new breast tissue.
- Skin Flap. Small flaps of skin from the area where the nipple is intended to be are raised to form a mound that becomes the nipple. Additionally, skin, fat, or synthetic fillers can be used to make the nipple more erect.
- Skin Graft. Your surgeon may use a skin graft if there isn’t enough tissue on the new breast to create a nipple. Grafts can be taken from the thigh, abdomen, the groin where torso and legs meet, or the crease of the buttocks.
- Autologous Graft. A portion of the nipple on your unaffected breast may be grafted onto your new breast if the nipple is large enough.
- Medical Tattooing. Nipple tattoos are becoming increasingly popular among breast cancer survivors who may want to avoid additional surgeries. Plastic surgeons and their medical staff perform medical tattooing that recreates the natural-looking areola and nipple but without elevation of the nipple. Many acknowledge that tattoo artists successfully use three-dimensional techniques to provide a more lifelike nipple and areola. Just like any tattoo, it may fade over time. It may be necessary to have the tattoo touched up.
Nipple-sparing is quite literal: sparing the nipple during a mastectomy. This may be an option for you if cancer isn’t detected in the tissue beneath the nipple and areola. Nipple-sparing leaves the breast looking virtually unchanged and intact, other than a small scar under the crease of the breast or out towards the arm.
Sensation in your nipple is possible with nipple-sparing. 30%-60% of women in a particular study reported sensation erectile function in the nipple, especially after six months to a year after surgery. Sensation in the nipple is not possible with a reconstructed nipple.
There is a small risk, about an 8% chance, that you could lose your nipple with this procedure. This happens because we remove all the tissue behind the nipple and that poses risk to an interruption of blood supply to it. It’s important to remember this is a case-by-case decision to be made between the patient and her breast surgeon.
Who is a Good Candidate for Nipple Reconstruction?
Anyone who does not have a nipple present and desires to have one. If you are happy with your breast mound and want a projection representing a nipple, you are a good candidate.
However, if you have very thin breast skin, or your tissue has been damaged due to radiation treatment, optimal results may not be able to be achieved with this procedure. During your consultation with Dr. Finkel, she will closely evaluate your breast and skin quality to determine the best treatment approach for you and your body.
Results and Recovery
Reconstruction of your nipple is typically an outpatient procedure that can be completed within one hour. Often patients will have mild pain or discomfort that can be treated with mild pain-killers. Most patients will be able to return to their normal activities in a few days.
It’s important to understand different variables including overall health and techniques used by your surgeon ultimately present different outcomes, and any severe pain should be reported to your doctor.
Your doctor will advise you on how to care for your new nipples. You may be sent home in a surgical bra or sports bra that holds the surgical dressings in place. You will be advised to wear the bra for a few days after surgery and typically will be removed when you arrive for your post-surgical exam.
The cost of nipple and areola reconstruction varies depending on where your procedure is performed and the surgeon you choose to work with. The Women’s Health and Cancer Rights Act (WHCRA) is a federal law that guarantees insurance policies that will cover mastectomies to also cover nipple reconstruction.
Otherwise, to reconstruct your nipple will cost you roughly $2,000. Medical tattooing can cost you anywhere from $350-$2,500.
Ultimately, nipple reconstruction is entirely up to you. As you think of your breast reconstructive surgery thus far, you may feel a little bit overwhelmed and exhausted from surgeries already. Fortunately, you can put off this final surgery until you feel ready if you feel it’s necessary at all.
If you have any further questions, would like to schedule a consultation to see if you are a good candidate for nipple reconstruction, or would like to discuss other options, reach out to Dr. Finkel today.
Dr. Finkel is one of the only female physicians in the greater Phoenix area. She offers a unique view to her patients with any aesthetic, age-related, or reconstructive requirements that you have in a relaxed and worry-free environment. Don’t let yourself be held back from your full potential any longer.