Nipple reconstruction and Areolar Tattoing

Nipple reconstruction can be performed once you are happy with the shape and size of your reconstruction and time has passed for you to heal. This can usually be done under local anaesthetic in a day case setting. The nipple is made out of the skin on your breast and then folded and stitched in order to create a nipple. The stitches used are absorbable and fall out spontaneously in 2-3 weeks time. You would be provided with an antibiotic ointment to apply locally and a sponge pad with a hole cut out in the middle to cover and protect the new nipple from any injury. You would be advised to wear the sponge in the bra for about 4-6 weeks.

How is the new nipple different from a natural one?

The nipple created by your surgeon will not be like your natural nipple and will not have any ‘feeling’.

It will not react to temperature or touch by flattening or becoming larger.

Depending on the type of breast reconstruction, reconstructed nipples may appear more or less “perky” than others. The new nipple tends to flatten with time and appear less prominent.

Complications

1. Partial or total Nipple necrosis: the success of the reconstructed nipple is dependent up on adequate blood supply and in some cases, if the blood supply is inadequate, the nipple may die. In that situation, surgery s not usually necessary and healing cuts spontaneously with scar formation and another attempt at nipple reconstruction could be considered at a later date. It is not uncommon for a small part of the nipple (usually the tip) not to survive and this is rarely of any significance and healing is spontaneous.

2. Asymmetry of nipple size and position: your surgeon will take utmost care to ensure symmetry of nipple position but depending upon the type of reconstruction and future changes in your opposite natural breast, you may have asymmetry in nipple position. The reconstructed nipple tends to flatten with time resulting in difference in nipple projection.

Alternatives to nipple reconstruction:

1. Areolar tattoing: Some women do not wish to have their nipple reconstructed and would chose to have areolar tattooing only.

2. Prosthetic nipple

3. Nipple share:This option involves taking a portion of natural nipple from your other breast (if it is large enough) and graft it to the reconstructed breast and involves a short general anaesthetic.