Breast cancer survivors face a number of difficult decisions along the road to recovery. Of course, the first big decisions have to do with treatment of the cancer and are made under the guidance of the patient’s physician and medical team. But as many women find, cancer free does not mean decision free.
In cases involving mastectomy, or removal of the breast tissue, a woman and her surgeon must also choose whether she will have breast reconstruction to regain her natural shape, and whether that reconstruction will include rebuilding the nipple.
Most folks tend to understand the concept of breast reconstruction, but the idea of nipple reconstruction isn’t as widely understood. As a plastic surgeon, working with breast cancer survivors is one of the most rewarding parts of my job and so to mark Breast Cancer Awareness Month, I hope to do my part by offering an explanation here.
Mastectomy and Removal of the Nipple
During a mastectomy, a surgeon will most likely remove all of the breast tissue, including the nipple and areola, until pathology tests show tumor margins are clear and that no further surgery is needed. While plastic surgery allows survivors to reclaim their shape with reconstruction, many women still desire the look and texture of the areola and nipple.
In cases where the entire nipple and areola are removed, a plastic surgeon can help to recreate the nipple a few months after reconstruction surgery. Here are 3 options for reconstructing the nipple:
1. Nipple Reconstruction Using Your Own Tissue
During this procedure, a plastic surgeon will use skin from near or around the nipple site to form a shape that resembles the nipple bud. This is the part that projects from the breast. In some cases, a surgeon will graft skin from other areas to create the areola.
About 3 months after the procedure, a specially-trained medical tattoo artist adds the finishing touches with a permanent nipple tattoo. Color and shading are used to produce natural-appearing results.
2. Nipple Tattooing Without Reconstruction
The second option is to receive a nipple tattoo on the reconstructed breast tissue without rebuilding the actual nipple.
In this case, shading is used to create the illusion of a 3D nipple, but the tissue itself stays flat. Unlike nipple reconstruction, there is no grafting and no further incisions on the body.
Since the reconstructed breast tissue is not as sensitive as a natural breast, the tattooing process tends to be less painful than a traditional tattoo. A single session is generally all that is needed, although some women choose to have their tattoos touched up from time to time.
3. Nipple Prosthesis
Many breast cancer survivors prefer to avoid further surgery after breast reconstruction. When this is the case, removable polyurethane nipples are available, which mimic a natural nipple in texture and color. Nipple prosthesis are sticky on the backside and can be easily worn and removed as desired.
If you would like to learn more about how breast reconstruction improves lives in Albany, I invite you to visit the breast reconstruction page on my website.