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Nipple Reconstruction

Nipple reconstruction and areola reduction are procedures used to create more aesthetically proportioned nipple-areolar complexes.  Issues that can be addressed include large nipples, long nipples, and disproportionately large areolas.  Additionally, the procedure is an important component and often the last step of breast reconstruction.  Although the nipple and areola can sometimes be preserved, in most cases they are removed with the rest of the breast tissue. We must then rebuild the nipple and areola using autologous tissue grafts from other areas of the patient’s body (usually the upper inside thigh or abdomen), tissue on the breast itself. Lastly,  tattooing can be used to create a more natural appear nipple and areola. 

Walkthrough

Let our experienced team guide you through your procedure from start to finish

The Preparation

To prepare for breast reduction, patients are asked to cease the use of all blood-thinning drugs (including aspirin, herbs, vitamins) for two weeks before surgery. If you smoke, you should quit for at least the two weeks before and after your operation. If you are over the age of 45, you will need to obtain medical clearance by an independent physician before undergoing surgery.Dr. Vallecillos may also require that you undergo a mammogram before the procedure, as well as after healing is complete. Typically, the breasts are also photographed and measured before and after the operation, to qualify results.

The Procedure

Anesthesia

If the nipple-areolar modifying procedure is being performed during or immediately following a breast reconstruction surgery, the patient will already be under general anesthesia. If the nipple reconstruction is being performed as an independent surgery, the surgeon may choose to administer either general or local anesthesia.

The Procedure

Several options for nipple and areola reconstruction exist. Dr. Vallecillos will discuss beforehand which options are best for you, given your specific diagnosis and circumstances. Some of the more commonly performed nipple reconstruction procedures are as follows:

Autologous Skin Graft

Tissue from the nipple of the opposite breast can be a viable donor site for construction of a nipple when it is large enough. However, if the nipple is normal-sized or small, both nipples can end up looking diminutive.

For the areola, a tissue graft can be taken from the upper inner thigh if the skin in that area has good pigmentation. However, these grafts tend to fade in color over time, and the donor site may develop a painful scar and exhibit chronic issues with healing.

Tattoo

Surgical tattoo is a simple, minimally invasive and very effective means of recreating the appearance of an areola. While tattoo cannot reproduce the texture provided by a skin graft, it does allow for a more exact color match and eliminates the possibility of complications at tissue donor sites. Over time the color will fade, and the nipple and areola may need to be tattooed again.

The Recovery

Patients should arrange to have friends, family members, or other caregivers available to help during the first week after surgery. Recovery time after nipple reconstruction depends on many factors, including whether it is performed at the same time as a breast reconstruction, as well as where donor sites for an areola skin graft (if used) are located. You should avoid having sex or performing strenuous exercise and/or heavy lifting for at least 4-6 weeks after surgery.The patient may also be advised to wear a soft tissue expander, such as the Brava device, for several weeks prior to the procedure to ensure that maximum volume is gained through the procedure. Dr. Vallecillos will be able to determine the best pre and post-operative care, tailored to your specific needs.

Breast Reconstruction

Before & After Images

Patient Details

Patient Details 

Frequently Asked Questions

Who is a candidate for nipple reconstruction?

You should consider nipple reconstruction if you’ve undergone, or are planning to undergo, breast reconstruction. These procedures are often completed together, although nipple reconstruction can be performed after a breast reconstruction.

Are there risks or side effects with nipple reconstruction?

You should expect some temporary swelling, tenderness, bruising and possible numbness near the incision sites and throughout the breast area. These will diminish and eventually disappear with time. As with all surgeries, there is a small risk of infection and bleeding.

How long do the results last?

Nipple reconstruction is permanent, though if tattooing is used, additional tattooing may need to be performed to correct color fading over time.

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