Nipple

areolar reconstruction

BEFORE & AFTER PHOTOS

*DISCLAIMER: This site contains graphic & surgical images that may be disturbing to some viewers.

This site is intended for individuals over the age of 18.

**Please note that none of the images posted throughout this site have been enhanced or photoshopped.

CAN I HAVE A NIPPLE AREOLAR RECONSTRUCTION?

Women who have had breast cancer surgery, where the breast and nipple areola have been removed to treat the cancer, often undergo breast reconstruction after the surgery.

*Please see FAQ Breast reconstruction following breast cancer

The last stage of the reconstruction after the breast mound is reconstructed, is to have the nipple areola reconstructed. This converts the breast mound into a more natural looking breast.

  • One option is a medical 3-D nipple areola tattoo placed on the reconstructed breast mound. This provides an excellent color and size match to a typical nipple areola but the tattoo is flat. There is no nipple projection.

  • The other, and more popular option, is to have a surgical nipple areolar reconstruction. This produces a nipple projection and areola surrounding the reconstructed nipple. This technique does not always produce the desired color match the patient desires. Over tattooing of the areola would then be required 3-6 months after the completion of the reconstruction to produce a more favorable color match. If the color match is satisfactory or the color is not an issue, then patients will forgo the tattooing option.

  • Some patients do not proceed with a nipple areola reconstruction following a breast reconstruction of the breast mound.

In the rare instance where a nipple areola is partially or completely lost following a breast reduction operation, a similar approach to nipple areola reconstruction is taken.


OPERATION:



nipple tattoo

Nipple Tattoo

Left Breast nipple tattoo using a 3D technique.

There is no nipple projection but the size and colour match are close to the natural right breast nipple.


  • Nipple Tattoo:

    • Nipple tattooing is done like any regular tattoo

  • Surgical:

    • This surgical procedure to build a nipple and areola is done under general anaesthesia as a Day procedure, (the patient goes home the same day).

    • There are numerous techniques described to create a nipple projection.

      • The areola is created using a skin graft (harvested from the groin or lateral breast) and placed around the reconstructed nipple.

      • A special dressing (bolus) is placed around the reconstructed nipple and areola. This is left in place and undisturbed for 5-6 days. The patient must keep this dressing dry (no shower).

      • At 5- 6 days, all the bandages and the bolus dressing is removed. The patient can then shower.

      • The incision around the areola is closed with dissolving sutures. All other sutures are removed.

    • Healing takes 7-10 days

    • The patients may shower daily, but should avoid strenuous sports for 6 weeks.


RISKS:

With any surgery there are surgical and anesthetic risks.

Aside from the rare risks of an anesthetic event, some of the general and specific surgical risks for this procedure would include:

  • Scarring 

  • Nipple tissue loss because of graft loss

  • Infection

  • Sensation change: the reconstructed nipple and areola will not have sensation

  • Discomfort

  • Asymmetry

  • Bleeding (hematoma):

    • if you take blood thinning medication, this must be stopped at least one week prior to surgery and one week after surgery

*This list is not complete.

During the consultation with the patient, Dr. Giuffre will outline and explain each of the risks in detail.


THE FOLLOWUP:

How often do I need to come back for a checkup after the surgery? 

Postoperative visits include:

  • a 1 week post op visit

  • a 6 week visit in the office to review the preoperative photograph and the surgical result.

The patient is allowed to shower after the first dressing change at day 5-6.  One week off work is recommended. Aggressive sports activity should be avoided for 6 weeks.

 If there are any patient concerns, Dr. Giuffre provides his home phone number for patient's direct access.

After the 6 week visit, if there are any future requests for an appointment, they are made directly with Dr. Giuffre’s office and an expedited visit is arranged.


FINANCING:

Will AHS (Alberta Health Services) cover  nipple surgery?

Nipple reconstruction following breast cancer surgery is covered by Alberta Health Services.