Nipple Reconstruction

Nipple Reconstruction
During a mastectomy, the nipple and areola (i.e. the pigmented area surrounding the nipple) are customarily removed. Therefore, nipple and areola reconstruction represents the final stage of a complete breast reconstruction. It should be noted that these procedures are completely optional. Some women may want only the shape of the breast to fill a bra and look natural in clothes.
Nipple and areola reconstruction is performed at a time when the surgeon and patient are both happy with the final shape and size of the reconstructed breast. Depending on the type of nipple and areola reconstruction performed, this may be done either in the operating room or as a "day surgery" procedure in the surgeon's office or minor procedures room. This procedure may be performed under local or general anaesthesia.
How is the procedure performed?
The nipple may be reconstructed by using a flap or a graft. Flaps are pieces of tissue that are moved from one location to another with their own blood supply intact. Grafts are pieces of tissue that are completely removed from their own blood supply and rely on the in-growth of a new blood supply at the new site.
Flap reconstructions have an advantage over graft reconstructions in that the bulk and projection of the nipple are generally more reliable. The main disadvantage of flap reconstructions is that new scars are left on the breast surrounding the new nipple location. Transplants, on the other hand, leave scars at distant locations.
In modern approaches to nipple reconstruction, the nipple mound is created from skin taken as a local flap on the reconstructed breast. Various local flaps have been described, including the Skate flap, the C-V flap and the Star flap. Regardless of which approach your surgeon chooses, the outcome will be a nipple mound. The areola can then be either tattooed, or it can be reconstructed with a skin graft taken from elsewhere on the body. Common donor sites for the graft include the abdominal scar from a flap reconstruction, the inner thigh, or the buttock crease.