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Nipple reconstruction

Introduction

Nipple reconstruction is usually performed in the context of a breast reconstruction procedure, however it may be necessary where there is a congenital absence of the nipple, or the nipple has been lost following previous trauma or surgery. The surgery aims to recreate the prominence of the nipple. Once the area is healed, the colour of the areola may be recreated tattooing, performed by a specialist nurse.

NIPPLE RECONSTRUCTION

  • Type of anaesthetic
    Local anaesthetic
    Length of surgery
    30 min to 1 hour
    Nights in hospital
    0 nights (day case)
    Scars
    beside the nipple

  • Recovery
    1-3 days off work
    2 weeks cushioned dressing
    2 weeks gentle exercise
    4 weeks strenuous exercise
    Follow-up
    1 week (dressing clinic)
    2 weeks
    6 weeks
    3 months

My approach

I understand that having a nipple reconstruction often marks the end of a long and emotional journey for a patient, and for that reason it is lovely surgery to be able to perform! The position of the nipple is determined by a number of factors, including certain standardised measurements, existing scars, the position of the nipple on the other side, and the patient’s wishes.

One aspect of this surgery that I emphasise, is the fact that many patients will initially think that their reconstructed nipple is too large. This is quite deliberate as not only is there post-operative swelling, but these reconstructions will tend to lose prominence and flatten with time.

The Surgery

The prominence of the nipple is created by raising two flaps of skin, which are then wrapped around eachother and stitched into place. A linear scar is made on either side of the new nipple, within the area that will ultimately be covered by the tattoo of the areola. As the area is usually quite numb to begin with, most patients find that this procedure is very tolerable under local anaesthetic, however if another procedure is being performed at the same time (e.g. liposuction, fat transfer, implant exchange, scar revision, etc.), then it may be done under general anaesthetic.