Nipple Areolar Reconstruction

Nipple and areola reconstruction is optional and will usually form the final stage of breast reconstruction after your mastectomy. This surgery is a separate surgery and involves the reconstruction of the dark area around the nipple (the areola) and the nipple itself. The surgery is conducted to make your breasts look more like the original breast. Sensation is not usually restored in this surgery as the nipple is commonly removed in cases of extensive cancer of the breast, which has the effect of severing the nerves innervating the nipple. In this case the feeling in your nipple will be lost, but the reconstruction can restore the appearance of the breast including the position, size, shape, texture, projection, and colour of the original (or remaining) nipple.

Tissue Transfer

The tissue to recreate the nipple is usually skin form the reconstructed breast folded to make a nipple shape. Your surgeon will sometimes use a tattoo to match the colour of the nipple to the other breast and to create an areola. Great care is taken by your surgeon in matching the appearance of the nipple to your original breast and achieving a result that can make you feel comfortable with your reconstruction.

As an Additional Surgery

Nipple reconstruction is usually conducted three to four months after breast reconstruction and may be performed as an outpatient procedure under local anaesthetic. This allows the reconstructed breast time to heal and settle into its new position, thereby giving your surgeon a better opportunity to place the nipple in such a way as to give a natural appearance to the breast.

In some cases a nipple-sparing mastectomy may have been conducted, where your nipple and areola are left intact and in place while the underlying breast tissue is removed. If your cancer was at an early stage and there was no sign of cancer in the skin or near the nipple then your surgeon may have been able to spare your nipple.

Using Implants and Nipple-Sparing Mastectomies

If you have larger breasts then the nipple can look out of place after a nipple-sparing mastectomy. This may be correctable through the use of breast reconstruction with implants, but can pose challenges even for the most skilled of surgeons, meaning that it is usually a better option to have a new nipple reconstructed after breast surgery.

Discussing your options for nipple reconstruction, or nipple-sparing, with your surgeon prior to undergoing mastectomy will give you a better understanding of the choices available if you decide to have breast reconstruction surgery.