Nipple and Areola Reconstruction After a Mastectomy

A mastectomy is often a necessary component of cancer treatment. Though mastectomy often prevents the disease from spreading, contributes to the cure, and greatly increases survival rates, it can leave some women emotionally upset. However, with advances in technology and surgical procedures, breast reconstruction has become a popular option for women who have undergone a mastectomy. Some studies have shown that the full positive effects of breast reconstruction are realized unless reconstruction of the nipple and areola areas are also performed.

Nipple and areola reconstruction often combine both surgical and non-surgical procedures. The patient’s anatomy and goals are assessed, and then the surgeon and the patient develop a plan for reconstruction. This can include the non-surgical use of permanent tattoos for pigmentation in areola reconstruction, and surgical flap techniques for nipple reconstruction.

Should Nipple and Areola Reconstruction be Immediate or Delayed?

Some surgeons feel that it is best to delay nipple and areola reconstruction until some time after breast reconstruction. This allows for the breasts to settle and may ensure better placement of the areola and nipple. However, many women who are told to wait to begin nipple and areola reconstruction, will never return to have it done. Many women don’t want to go back under the knife and may just live with their nipples and areolas they way they are. This is a strong argument for undergoing nipple and areola reconstruction immediately instead of waiting. 

Areola Reconstruction

  • Skin grafts from other parts of the body can be used
  • Tattoos have become a popular option because they can be used to create definition and pigmentation. It is important to not with tattoos, pigmentation can change over time; touch-up procedures can fix this issue.

Nipple Reconstruction

  • Flaps of local tissue are used to develop a three-dimensional projecting nipple.
  • Donor tissue and injectable fillers can be used to create a nipple.
  • Excess tissue during a breast reconstruction procedure can be used to create the nipple

Creating a nipple and an areola that are aesthetically similar and balanced can be a challenge for any surgeon. Creating a nipple and an areola that remains balanced and symmetrical over time is an even greater challenge. There are several tools that a highly skilled and trained surgeon can use to create symmetry and balance; the most important tools are experience and training. Using a board-certified plastic surgeon with years of experience in nipple and areola reconstruction will ensure you achieve the  best possible results after a mastectomy.