cancer treatment - breast reconstruction - nipple
nipple reconstruction
Following breast reconstruction (or
another procedure necessitating removal of the nipple) the majority of
women wish to have breast symmetry and contour restored with the
construction of a new nipple. This can usually be achieved under local
anaesthesia if desired. The technique involves creating the new nipple
from breast skin, often the panel of skin moved up as part of the
breast reconstruction.Whilst it is feasible to have the nipple made at the time of the original surgery, the best results come from a delayed procedure, usually after three to six months. There are several reasons for this:
- blood flow to the skin of the reconstruction takes a while to recover and an additional early injury is best avoided.
- position of the new breast changes during the first three months after surgery and immediate nipple reconstruction runs the risk that the final position will be unsymmetrical.
- adjuvant treatment, particularly radiotherapy, can scar the initially delicate reconstructed nipple causing it to shrink.
A tattoo will create the new areola (the brown/red skin surrounding the nipple). This occurs approximately 3 - 6 months following the nipple reconstruction surgery and can be done at the clinic. It may take more than one session of tattooing however to ensure a colour match with the other side. Tattooing the areolar also covers the scars from creating the nipple very effectively.
Whilst the new nipple should match the other side in terms of shape, size and colour it will not have nipple sensation. It should however retain normal skin sensation.
Above: Schematic diagram of the 'skate' flap technique.
