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Nipple and Areola Reconstruction

Nipple and Areola Reconstruction

The reconstruction of the nipple is the ultimate of breast reconstruction. The nipple reconstruction should never be carried out together with the reconstruction of the breast itself in the first operation because obvious alterations of shape might take place during the first ½ to ¾ of a year after the operation and the final result can therefore only be judged after this period. Furthermore, correcting operations to the other side should be carried out first in order to be able to determine the position of the new nipple correctly. Generally, there are different ways to create a new nipple.

Nipple Reconstruction in Detail

Nipple Reconstruction in Detail

Reconstruction of the nipple by local tissue
The patients choose the position of the new nipple before the operation. The reconstruction of the nipple is performed by relocating small parts of skin in the same region, so called local flaps. A new nipple can be formed from the tissue at hand employing different techniques. Initially, the nipple has to be extensively larger, as it loses up to 50% of its size in the further process of healing.


Reconstruction of the nipple using parts of nipple tissue from the opposite side, nipple sharing
If the opposite nipple is big enough, the lower half of it can be used to form the new nipple. This is our favourite method as it is the most natural way of reconstruction.

Risks and possible complications
The main risk is the loss of the new nipple due to an inadequate blood supply. The nipple does not became as sensitive as the original nipple was. 

Follow-up treatment
A suitable bandage is applied directly after the operation to protect the nipple. This must be worn continuously for at least a week. Further specific follow-up treatment is not necessary.

Areola Reconstruction in Detail

Areola Reconstruction in Detail

Reconstruction of the areola with skin from the groin
Skin from the groin can be used for the reconstruction of the areola because the groin and nipple match in colour. A linear scar remains in the groin only. The skin graft is placed around the nipple which is formed in the same operation and fixed with a dressing. The skin is completely healed after about a week.

Risks and possible complications
The skin often darkens after the operation which does not seriously affect the optical result. Loss of skin is rare. In these cases the operation has to be carried out again or, alternatively, the areola has to be tattooed/pigmented

Follow-up treatment
A suitable dressing is applied directly after the operation to preserve the nipple. This must be worn continually for at least a week. Further special follow-up treatment is not necessary.

 

Reconstruction of an areola by intradermal pigmenting (tatooing)
This is not a 'real surgical procedure', however it gives rewarding results. It is a relatively easy procedure, although a few sessions might be necessary to carefully find the right colour and intensity.