Reconstructing the Nipple and Areola After Breast Surgery
When treating breast cancer with a mastectomy, the nipple is typically removed along with the rest of the breast. (Some women might be able to have a nipple-sparing mastectomy, where the nipple is left in place. This is discussed in more detail on our page about mastectomy.)
If you’re having breast construction after your mastectomy, you can decide if you want to have the nipple and the dark area around the nipple (areola) reconstructed through surgery or tattooing, or both.
Nipple and areola reconstruction
Nipple and areola reconstructions are usually the final phase of breast reconstruction. This is a separate surgery done to make the reconstructed breast look more like the original breast. It can be done as an outpatient procedure. It’s usually done after the new breast has had time to heal (about 3 to 4 months after surgery).
Ideally, nipple and areola reconstruction matches the position, size, shape, texture, color, and projection of the new nipple to the natural one (or to the other one, if both nipples are being reconstructed). Tissue used to rebuild the nipple and areola comes from the newly created breast or, less often, from another part of your body. In some cases, doctors build up the areola and nipple area with donor skin that’s had the cells removed. If a woman wants to match the color of the nipple and areola of the other breast, tattooing may be done a few months after the surgery.
Some women opt to have just the tattoo, without nipple and areola reconstruction. A skilled plastic surgeon or other professional may be able to use pigment in shades that make the flat tattoo look 3-dimensional.
Another option for women who might not want further surgery or tattooing are nipple prosthetics, which are made of silicone or other materials and look and feel like real nipples. They can be attached to the chest and then taken off when you choose to.
American Society of Plastic Surgeons. Breast Reconstruction. Accessed at www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction.html on June 1, 2016.
Breastreconstruction.org. Accessed at: www.breastreconstruction.org/index.htm on June 1, 2016.
Djohan R, Gage E, Bernard S. Breast reconstruction options following mastectomy. Cleve Clin J Med. 2008;75 Suppl 1:S17-23.
Farhadi J, Maksvytyte GK, Schaefer DJ, Pierer G, Scheufler O. Reconstruction of the nipple-areola complex: An update. J Plastic, Reconstructive & Aesthetic Surgery. 2006;59:40-53.
Gerber B, Krause A, Dieterich M, Kundt G, Reimer T. The oncological safety of skin sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction: An extended follow-up study. Ann Surg. 2009;249:461-468.
Morrow M, Burstein HJ, Harris JR. Chapter 79: Malignant Tumors of the Breast. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.
Last Medical Review: June 1, 2016 Last Revised: August 18, 2016
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