While some patients are able to undergo a nipple-sparing mastectomy, many emerge from mastectomy and reconstruction without a nipple or areola. Nipple reconstruction procedures use local skin flaps created from the skin on the reconstructed breast to construct a nipple.
Nipple reconstruction with skin flaps using skin on the reconstructed breast.
Nipple areola reconstruction is suitable for most breast reconstruction patients. However, those with thin, insufficient, or radiated skin may not be ideal candidates for nipple areola reconstruction. Many of these patients are still candidates for a 3-D tattoo that can provide the appearance of a nipple on its own.
Types of Nipple Areola Reconstruction
Local Skin Flaps
Combination Of Local Skin Flaps And Skin Grafts
- A patient and plastic surgeon work together to choose an approach based on patient preference and reconstructed breast skin quality
- The patient is marked
- Small incisions are used to elevate local skin flaps
- The local skin flaps are shaped to replicate nipple contour and texture
- The donor site incisions are closed
- In some cases, skin grafts from another part of the body are moved to the breast and shaped into an areola
- After all incision have healed, a tattooing procedure provides natural nipple and areola color
Risks & Benefits
Nipple areola reconstruction carries a small risk of wound breakdown. However, local wound care and/or wound repair in the office generally resolve any issues. Patients who have undergone radiation treatment are more likely to have this problem. These patients may be better served by a 3-D nipple areola tattoo. A delayed procedure in which local skin flaps are elevated and closed in one procedure and the nipple is reconstructed later can help reduce the risk of wound issues.
Nipple areola reconstruction is generally well tolerated with few risks. Many patients find that it is an emotionally restorative finishing touch to their breast reconstruction.