Nipple reconstruction is a plastic surgery procedure in which a patient's nipple is rebuilt with skin flaps. This procedure is most commonly performed as part of a breast reconstruction after breast cancer, although patients may also experience nipple loss or damage as a result of trauma and opt for reconstruction. A plastic surgeon performs the procedure, usually working with the patient throughout the breast reconstruction process.
Not all patients with breast cancer opt for breast reconstruction and for those who do, nipple construction is an optional aspect. Some patients do not want to go through another procedure to rebuild their nipples and may decide to go without, although the nipples can be reconstructed in the future if these patients change their minds. Information about breast reconstruction is often provided early in the stages of breast cancer treatment because the surgeon who performs the mastectomy can take special steps to preserve breast tissue which can be used for reconstruction.
The breasts must heal from the breast reconstruction surgery before a nipple reconstruction can be performed. If the nipple is rebuilt too early, swelling and settling of the breasts can cause the nipple to drift out of position, which is not desirable. The plastic surgeon will conduct an exam to confirm that the breasts are fully healed and at their final shape, size, and position. Then, the nipple reconstruction surgery can be performed.
In the nipple reconstruction surgery, a skin flap is taken from a location such as the abdomen or the thigh and it is sutured in place and shaped by the surgeon to create the mound of an areola and nipple. Once the skin flap has taken and healed, the patient can receive a tattoo to darken the skin so that it looks more natural. It is important to note that the patient will not have sensation in the reconstructed nipple; it is an aesthetic procedure only.
Like any surgical procedure, nipple reconstruction does have some risks, although they are very low. The skin graft may be rejected, especially if the patient had radiation therapy, and it is also possible for infection to set in at the surgical site or the area from which the graft was taken. Following aftercare directions closely can help to reduce some of these risks and increase the chance that the patient will heal successfully. Patients should also be aware that over time, the rebuilt mound of the nipple tends to subside.