If you have had your nipple and areola (the darker tissue surrounding the nipple bud) removed as part of your mastectomy, you may wish to have it reconstructed. This is the final stage of breast reconstruction surgery. The nipple bud/projection can be created with surgery.

Nipple reconstruction with local flaps

The nipple could be created using flaps of skin from the reconstructed breast. Usually under a local-anaesthetic, the surgeon will cut an arrow/star/clover leaf shape into the skin and use this to reshape into a nipple bud. The result will be a protruding piece of tissue (nipple bud) and straight scars either side.

Nipple reconstruction using nipple sharing

Nipple-sharing is a technique that can be used to create a nipple bud reconstruction. This is a useful technique if your natural breast has a large nipple. Half/a portion of your natural nipple can be removed and grafted on to your reconstructed breast.

Nipple reconstruction using other areas of the body

Some units may offer nipple reconstruction using another area of the body as a graft. Some donor sites could be labia majora, ear lobe, or tissue from the great toe. Any of these options need to be discussed with your surgeon.

What are the risks of nipple reconstruction surgery?

All surgery carries some risk and uncertainty. The following gives the most common or most significant problems that can occur:

  • As in any surgical procedure there is a small risk of bleeding. This is not likely to be anything more than slight ooze and will be contained in the dressing.
  • Infection can occur in the wound. If infection does happen it may delay wound healing and antibiotic treatment may be required.
  • There may be failure of the blood supply to the new nipple or areola. The tissue that has been grafted or rotated to create the new nipple or areola may not maintain its blood supply and may die. Usually, an alternative method of nipple or areola reconstruction can be offered to you if this happens.
  • The nipple projection will flatten over time to some extent. There are no ‘working-parts’ therefore bras and clothing will cause it to flatten. Sometimes it can flatten significantly and may need reconstruction again. The surgeon will deliberately create a larger nipple to allow for shrinkage.
  • Tattooing may also result in a slight flattening/shrinkage of the reconstructed nipple.

Procedure diagram

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