Nipple Reconstruction: The Final Step for Cancer Recovery

nipple reconstruction

Nipple reconstruction and tattooing is a procedure performed on women who have had a mastectomy and subsequent breast reconstruction. The process of reconstructing and coloring the nipple and areola is often the step that women consider the final step toward overcoming the battle with cancer, and becoming whole and healthy once again, regaining after years of struggle an integral part of who they are.

This important step may be done following any of the mastectomy reconstructive procedures. Many mastectomies are unable to save the nipple and areola tissue, and even those that are able to save the nipple may sometimes require cosmetic touch ups.

Nipple tattooing is a viable way for women to once again feel confident and comfortable in their breasts. It also detracts attention from the scars following surgery, as the nipple becomes the focal point of the breast once more.

Reconstruction Using Skin Graft

skin graft

The first method of completing nipple reconstruction is by forming a nipple and areola on the breast using a skin graft. This is a quick procedure usually performed in a hospital or outpatient facility using a local anesthesia.

The grafted tissue used to recreate the areola is typically taken from the inner thigh or groin area, as the texture of the skin there closely mimics that of an areola. The tissue forming the erect nipple is most commonly from the healed breast tissue, with the grafted skin placed around it to form the areola. If the breast tissue is too thin, the nipple may also be formed from the skin graft.

The surgeon will make a ‘z’ shaped incision, twisting the tissue up to form the nipple. The grafted skin is then sutured around this, onto the skin of the breast, creating the perky ‘projection’ of a nipple and areola.

Reconstruction Using Breast Tissue

The alternative method for nipple reconstruction without skin grafting to create an areola, is to cut a ‘z’ flap in the healed tissue of the breast itself. This is called a double opposing tab. Doctors may also cut the CV tab, which is shaped similar to a silhouette of a nipple. Once the cut is made, the surgeon will wrap the flap of skin around itself and suture it to hold it in place, achieving the illusion of an erect nipple.

After the skin has healed, the patient may then have color tattooed onto the nipple and surrounding area where the areola would be located. Your surgeon will match the tattoo color to your other breast or to pre-operation photo’s. If both breasts have had reconstruction, you may choose the color best suited to your skin tone. The plastic surgeon will use standard tattooing equipment, and use shading techniques that will create an image of a natural looking breast.

Nipple Tattoo Without Reconstruction:

nipple tatto

Some women do not like the appearance of a pert nipple, and instead choose to forego the nipple reconstruction and only have tattooing. Such women may have a textured, shaded tattoo applied to the breast that will create an illusion of a normal nipple.

This procedure usually takes under an hour, in which the surgeon will match the color of the existing nipple to the reconstructed breast, or to pre-operation photos if a double mastectomy was performed. Again, this tattooing is customizable, and so the patient may choose whatever color she feels looks best with her skin tone.

Using standard tattooing equipment, your plastic surgeon will use different shading techniques. With proper coloring, a 3 dimensional look can be achieved. Some call this the ‘illusion of protrusion’, and when done by a professional, can truly make the breasts look normal again.

Healing their Hearts:

Nipple reconstruction--using both the reconstructive tattoo method and the tattoo method--has been so effective that many people, including doctors, are unable to determine from sight whether or not a nipple tattoo has been applied, or if nipple saving techniques were used during the mastectomy.

This is a delicate and meaningful step for breast cancer survivors. Many women are overcome when they see their breasts restored to a natural, beautiful, almost pre-cancer look. Thankfully, recovery from this procedure is swift, and there is minimal pain involved.

Dr. McIntosh loves performing reconstructive surgeries for cancer victims. He feels honored to help women come out of the battle with cancer, not only physically healthy, but emotionally and spiritually healthy as well. You can read more on his blog.


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