Following a breast reconstruction, the final step in the surgical journey is to make a nipple. The nipple really completes the appearance of the breast reconstruction to the extent that when I am discussing a nipple reconstruction, it is one of the few operations that I strongly encourage women to have as it transforms the appearance of their breast. There are a number of ways a nipple can be reconstructed, the most common of which is to draw a pattern in the desired location of the new nipple which can then be cut around, re-stitched in a careful manner to create a three-dimensional small cylindrical structure (the new nipple) from the previously flat area.
Once the wound has healed and the scars have started to mature (usually by six weeks at least), tattooing can then be organised to add colour to the nipple and surrounding area to create an areola.
There are in addition, other ways of reconstructing a nipple which may be more suitable in certain cases, for example if there is a large nipple on the other breast this can be reduced and the excess that has been removed can be grafted on to the new breast as a “nipple share procedure”.
If there isn’t enough lax tissue to make a new nipple from flaps of skin and there is no large nipple on the other side then grafts can be taken from other areas, these include the labia, the toe and even the ear lobe!
At the end of the day a nipple really does complete the breast reconstruction and whether it is recreated surgically or even simply tattooed to give an illusion of a three dimensional nipple it is a small procedure that makes a very big difference.