This is a simple procedure to recreate a nipple in patients who have no nipple as a result of mastectomy, trauma or congenital absence. Rearranging skin from the surrounding area creates the nipple mound. This is called a local flap. The nipple and surrounding area will be tattooed at a later stage to form the areolar. Thus there are no obvious scars from this technique. If the nipple reconstruction is performed on its own it is a local anaesthetic procedure (you will be awake) but if other work is planned at the same time, it may be done under general anaesthetic (you will be asleep). Tattooing is carried out 3 months after the nipple reconstruction, when the scars have settled.
What does the operation involve?
A small U-shaped skin flap with side arms is raised from around the site of the new nipple. The side arms are curled in and attached end to end to provide the projection and the u shaped area is the lid. A small amount of fat is included in the flap to give bulk to the nipple. The raw area left where the skin is borrowed is simply closed directly.
Your incisions will be closed with a dissolvable suture that does not need removing. You will have a waterproof dressing covering the area. You can shower as soon as you want.
What are the risks and side effects of surgery?
Having surgery should be a very positive experience. Complications are infrequent and usually minor. However, no surgery is without risk and it is important that you are aware of any related complications with this minor surgical procedure.
Scar – scars tend to settle remarkably well and will be concealed by the tattooed areolar. However some patients heal with thick scars and this can make them more noticeable.
Bruising and swelling – is uncommon.
Infection – is very rare but may require antibiotics.
DVT/PE/fat embolus – following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and move to your lungs. If the blood clot is large enough it could prove fatal. In order to reduce any risks of this we give you special stockings to wear in bed and a blood thinning injection if you are not mobile.
Wound healing problems – are rare but can occur if the skin is under tension. These healing difficulties can range from minor problems, such as small scabs, to larger issues, such as nipple loss. Patients who have diabetes, smoke, are obese or elderly are at an increased risk of delayed healing.
Flattening – there is a tendency for the nipple reconstruction to flatten slightly with time.
All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to contact me. Decisions about cosmetic surgery should never be rushed.
What happens after the operation?
You will have dissolvable sutures and a waterproof dressing.
Before you leave the hospital, you will be given a follow up appointment to see the nurses at a week to check your wounds and remove the dressing. I would normally see you at 6 weeks or sooner should you have any problems.
What is the estimated time for recovery, absence from work and return to usual activities?
Recovery times vary from one patient to another but most will return to work the next day. You can resume normal activities, although swimming should be avoided for 2 weeks.
How much does the surgery cost?
Pre and Post-Operation Instructions (PDF)
I hope you find this information useful. If you have any questions or require a little more information then please do not hesitate to contact me.