Nipple Reconstruction

What is nipple reconstruction?

A nipple reconstruction is a procedure to recreate a nipple in patients who have no nipple, because 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. This will cover any scars from the nipple reconstruction, so they cannot be seen.

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.

Surgery for nipple reconstruction is a simple procedure taking approximately 15 minutes to perform. 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 wish.

Having plastic surgery should be a very positive experience and decisions about it must never be rushed.

Complications are infrequent and usually minor. However, all surgery has risk, and it is important that you are aware of the possible complications. All the risks will be discussed in detail with you at your consultation. However, if you have further questions or concerns, please do not hesitate to discuss them with me.

There will be some discomfort for the first day and occasionally bruising may occur, but this should resolve rapidly.

Scars:  There is always some scarring after surgery, but this is hidden by the micropigmentation (tattoo) procedure to colour the nipples and should not be visible.

Bleeding: This is uncommon, however if this does occur it is unlikely to require any further surgery and can be stopped with temporary pressure on the nipple.

Infection: This is very uncommon but may require antibiotics.

Flattening: There is a tendency for the nipple reconstruction to flatten slightly with time. If this occurs, then it can simply be repeated.

Asymmetry: The reconstructed nipple will never be identical to a natural nipple and there may be differences between the nipples, although they should be very similar.

All the risks outlined above will be discussed in detail at your consultation with me. However, if you have further questions or concerns, please do not hesitate to ask. Decisions about cosmetic surgery should never be rushed.

A light waterproof dressing is applied, and you will be able to go home.

Before you leave the clinic, you will be given a follow up appointment to see the nurses at one week post-operatively to check your incisions and an appointment to see me in Clinic 2 weeks’ time.

Scar Advice
Once the dressings are removed, I recommend that you massage the incisions, using small circular motions at least twice a day for 5 minutes. You can use any moisturising cream of your choice and apply firm pressure until it blanches.

The scars will also benefit from silicone scar gel (ScarAway® or Kelo-Cote®) twice a day, which will soften and fade them, as well as applying sunblock for 12 months to provide sun protection.

The ScarAway® can be purchased from Healthcare Pharmacy at Governors Square in Grand Cayman.

You should take things easy for the first week and most patients return to work by 1 week. You can drive from as soon as you are comfortable, which is normally between 1 to 2 weeks. Most patients return to the gym at 2 weeks, and I recommend you wear your support bra for 4 weeks.

Surgical fees are a combination of the clinic costs, and the surgeon fees, as well as any consumables. In breast reconstruction patients the fees are normally cover by your health insurance, however most patients have a co-pay of 20% and certain policies only cover one breast and half of the other breast. This means you may have to contribute towards the cost of your surgery. Any fees will be calculated, and you will be informed of the potential fees at your consultation.