Nipple Reconstruction

Following breast reconstruction (or another procedure necessitating removal of the nipple) the majority of women wish to have breast symmetry and contour restored with the construction of a new nipple.

This can usually be achieved under local anaesthesia if desired. The technique involves creating the new nipple from breast skin without the need to transfer any skin or tissue from another site.

Whilst it is feasible to have the nipple made at the time of the original surgery, the best results come from a delayed procedure, usually after three to six months. There are several reasons for this:

  • the blood flow to the skin of the reconstruction takes a while to recover and an additional early injury is best avoided.
  • the position of the new breast changes during the first three months after surgery and immediate nipple reconstruction can result in ultimate asymmetry.
  • adjuvant treatment, particularly radiotherapy, can scar the initially delicate reconstructed nipple causing it to shrink.

The preferred technique for reconstruction involves surgically raising a star-shaped flap of skin and fat in the position of the new nipple. Initially this is made too large and is rather 'raw' under the dressing but over the next few weeks it contracts as it heals.

Dissolvable sutures will be used and a new areola (the brown/red skin surrounding the nipple) can be tattooed at a later date. It may take more than one session of tattooing however to ensure a colour match with the other side. Tattooing the areolar also covers the scars from creating the nipple very effectively.

Whilst the new nipple should match the other side in terms of shape, size and colour it will not have nipple sensation although it may retain normal skin sensation.