Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

Nipple reconstruction is a minor procedure with a good cosmetic results

Nipple Reconstruction Overview
Nipple reconstruction can often ‘finish’ a breast reconstruction. It is a relatively minor operation performed under local anaesthetic. However, it is not essential and some patients elect not to have it doneĀ  – as with all areas of breast reconstruction, the decision lies with the patient.

Nipple reconstruction can be performed during an immediate reconstruction but is more commonly performed some months after a reconstruction is complete. The best option will depend on the individual patient case, but Stephen McCulley prefers to do it at the same time of most immediate reconstruction surgeries. If the patient has opted for a delayed reconstruction Stephen will perform the nipple reconstruction as a separate operation at a later date.

There are broadly two different ways to perform the surgery. The advantages of the surgery is that there is no need for anaesthetic and can be treated as a day case. The nipple can shrink over the first 6-9 months and therefore tends to be made larger to start with.

Flap Based Nipple Reconstruction
Stephen McCulley’s preferred method is to reconstruct the nipple using small pieces (flaps) of skin on the reconstructed breast which are ‘wrapped’ around themselves to make a nipple.

Nipple Share Reconstruction
This takes half of the nipple from the opposite breast which is then grafted onto the reconstructed breast (similar to a skin graft).

With both techniques the aereolar (coloured disc around the nipple) is then created with the use of a tattoo around 8-12 weeks following surgery. The tattoo is done using pigments to best match the colour of the opposite nipple. Patients should be aware that the process might need repeating over time.

Prosthetic Nipples
Another option is to have a rubber moulded nipple made. This can achieve a very realistic result as it will be moulded on the opposite nipple.

If you are considering having a nipple reconstruction as part of your treatment Stephen McCulley will discuss the best option for you during your consultation.

Medicines
A full medical history will be obtained before any surgery. As a precaution, do not take any over the counter medicines or herbal remedies prior to surgery or for 3 days following. Also avoid aspirin, ibuprofen and Voltarol based tablets. It would be useful to bring a list of any prescribed medications to your pre-op assessment.

Smoking
If you are a smoker, try and stop around the time of the procedure as it can reduce the chances of complications.

Surgical Recovery & Final Outcome
– Length of stay in hospital – day case.
– Length of surgery – usually 30 minutes.
– The patient will not need to spend any time in bed and will be able to walk straightaway following surgery.
– Time to exercise – patients should be able to exercise after 2 weeks.
– Time to full recovery – depending on whether this is part of an immediate or delayed reconstruction, patients should feel fully recovered after 2 weeks, or 3 months if recovering from other surgery.
– Dressings – patients will wear dressings on the nipple and breast for 2-3 weeks.
– Driving – Patients should avoid driving until they are completely free of pain and restriction, and be able to confidently perform an emergency stop. This is to ensure they will be covered by their insurance policy. It may take up to 2 weeks to recover sufficiently.
– There is a 2% chance of experiencing part or total nipple reconstruction failure.

Please do not hesitate to contact us if you have any questions or would like to obtain costs.