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Nipple Reconstruction St. Louis

Making the Breast Complete Again

Many women undergoing removal of cancer from the breast need to have the nipple removed as well. This may be for oncologic safety due to the location or type of cancer, and desire to prevent recurrence of the tumor. Other times this is necessary from an aesthetic perspective so your plastic surgeon can better reshape a larger or droopy breast. Although this may sound devastating at first, rest assured that new nipples can be reconstructed by a variety of methods once the main breast reconstruction has had time to settle.

During a mastectomy, all of the breast tissue is removed. This also removes the normal nerves traveling through the breast tissue that supply sensation to the skin and nipple. Thus, women who undergo nipple-sparing mastectomies and reconstruction no longer have the same nipple sensation and function. However, the presence of the nipple areola complex helps make the breast appear complete and many women state it makes them feel whole again. We realize this importance and our surgeons will discuss nipple reconstruction with all of their patients as they progress through their reconstructive process.

New nipple reconstruction is usually performed 3 months after the breast mound reconstruction is complete. This gives time for the tissues or implants to “settle” into their final position. Your surgeon will make precise measurements coupled with an artistic eye to identify the best location for the new nipple(s), whether matching a normal breast on the other side or creating nipples for bilateral reconstruction patients. A new projecting nipple can be surgically created using the existing breast skin. This is often performed in the office, under local anesthetic, and takes approximately 20-30 minutes per nipple. After allowing time for this to heal, the new nipple will be tattooed in the office to infuse color and create the surrounding areola. For women who do not desire a projecting nipple, tattoos alone can be performed. A referral to a local 3D nipple tattoo artist can also be recommended.

 

QUICK FACTS:

  • Length: 20-30min per nipple
  • Anesthesia: Local numbing injection
  • Office procedure
  • Recovery: 1 day
  • Side Effects: Bruising, decreased projection and pigment over time

NIPPLE RECONSTRUCTION CAN:

  • Build a projecting nipple
  • Create a pigmented areola
  • Improve nipple symmetry
  • Increase confidence about breast appearance
  • Help women feel complete again

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PREPARING FOR NIPPLE RECONSTRUCTION

Smoking and all forms of nicotine should be stopped at least 2 weeks prior to any nipple surgery. This includes e-cigarrettes, patches, and gum.

Any medications and supplements which cause an increased risk of bleeding should also be stopped 2 weeks prior to any major surgery. Please see our list of medications and supplements to avoid. As always, make sure to check with your doctor before stopping any medications.

NIPPLE RECONSTRUCTION TECHINQUE:

Your surgeon will choose the optimal location for the projecting nipple(s). Using geometric principles, they will surgically reshape the central breast skin to create a small cylinder resembling a nipple. Postoperative dressings and padding will be placed to protect the nipple from compression, which the patient can then perform at home for the next 6-8 weeks until healing is complete. Dr. Scholl’s corn and callous pads, or small gauze pads often work great for this

RECOVERY FROM NIPPLE RECONSTRUCTION

This is an office procedure performed under local anesthetic. Patients can drive themselves to the appointment, without eating or drinking restrictions. This is not an overly painful procedure, and most patients need only Tylenol or other over the counter pain medications for a few days afterwards. Most patients can resume normal light activities immediately, and shower within 24-48 hours. Avoid heavy lifting or straining for 1 week. Nipple pads and protection will need to be worn for 6-8 weeks afterwards.

FREQUENTLY ASKED QUESTIONS
Do you Have a Question?

A: Yes. Both the projecting nipple creation and subsequent tattooing by one of our surgeons are covered by insurance. However, 3-D tattooing by our local tattoo artist is not covered, and is an out of pocket expense.
A: Patients need to avoid compression of the newly created nipple for at least 6-8 weeks after correction. This can be done with stacked gauze, pads, or other simple solutions such as Dr. Scholl’s corn & callous pads.
A: This depends on whether one or both sides are being corrected. Also, most nipples will lose approximately 50% of the immediate postprocedure projection over 1 year. Our surgeons uses meticulous techniques to try and make the nipples as symmetric as possible. He will take into account the anticipated settling of the nipple, and may recommend a slight overcorrection so that the final, lasting result is at the desired length.

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