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Nipple
and Areola Reconstruction |
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Nipple and
areola complex reconstruction is begun some months after the
breast mound swelling has diminished and the shape of the breast
has settled in. Premature placement of the nipple and areola
will cause it to be either too high or too low.
Under either general or local anesthetic, the new nipple is
outlined on the peak of the breast mound. Using tissues from
this area, the nipple is raised and fashioned. A skin graft is
then taken from the upper, inner part of the thigh to form the
surrounding doughnut, or areola, leaving behind a fairly
inconspicuous thigh scar. The operation is usually performed on
an out-patient basis and is accompanied by some tenderness in
the thigh donor site for a week or two.
The shape and projection of the new nipple and size of the
areola are approximated to that of the opposite breast. However,
the color of these structures may not be identical to the
original. When this is a problem, tattooing of both the nipple
and areola may produce more acceptable results. Sometimes simply
tattooing the shape of a nipple and areola on the mound will
give the illusion of having a completed reconstruction, although
authentic projection is lacking. Alternatively, the nipple is
rebuilt and the surrounding areola is tattooed without the use
of a skin graft.
A less frequently used method is taking part of the nipple from
the opposite breast to fashion a nipple for the new breast.
However, the other nipple may be too small to be used, and there
is a risk that sensation in the existing nipple will be
diminished.
The nipple from the original breast containing the tumor can
rarely be used on the reconstructed breast. There is concern
that some cancer cells will be transferred to the newly formed
breast. Besides, with the available technology, nipple and
areola formation has been elevated to a refined art.
Often, two operations can be combined so that the nipple and
areola are fashioned simultaneously with the remolding of the
opposite breast. The newly fashioned nipple and areola
transforms the reconstructed breast to appear more like the
original. Unfortunately, though, the new nipple and areola will
not have the original nipple’s unique sensitivities.
Sometimes a false nipple can be used. These are made of soft
plastic and simply adhere to the peak of the new breast. The
false nipple will give an authentic projection under your
clothes but, again, will not have the original nipple’s
sensitivity nor will it be a permanent part of the breast.
Nipple and areola formation is usually regarded as the final
step which completes the reconstruction. Many women see this
step as an ending to the struggles, physically and
psychologically, which began with the initial diagnosis of
breast cancer.
BACK |
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Roses Grown and Photographed By
Dr. Jeffrey Rosenthal |
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