Why it matters
For many people, the breast does not feel complete until a nipple and areola are present. Nipple reconstruction is usually the last stage of breast reconstruction after mastectomy. It is optional, and some people choose tattooing alone, or nothing at all.
When it is done
It is usually planned after the reconstructed breast has healed and settled, which commonly takes a few months, and after any radiation or other treatment is complete. The position can then be chosen carefully to match the other breast and the shape of the reconstruction.
How it is done
The nipple is typically created from a small flap of the skin of the reconstructed breast, which is folded and sutured into a raised shape. This is done under local anesthetic in many cases. Several designs exist, and the choice depends on your skin and your goals.
The areola is then created, most often by medical tattooing, which colors the area to match. A three-dimensional tattoo can give the appearance of projection and can be done alone for someone who does not want surgery.
- Local flap reconstruction to build projection
- Medical tattooing for the areola, and sometimes alone for the whole nipple look
- Removable adhesive nipple prostheses as a non-surgical option
What to expect
A reconstructed nipple usually flattens somewhat as it heals, and the projection is often less than the first result. Sensation is generally limited. Color can fade over time and may need touch-ups. Complications can include delayed healing, loss of projection and the need for a revision.
A related topic
When the original nipple is saved during mastectomy, that is a different approach called nipple-sparing mastectomy, which is possible only for selected people and is a decision made with your cancer surgeon.