The final stage of breast reconstruction is recreating the nipple and the pigmented area around the nipple called the areola. Nipple and areola replacement is an optional procedure because it isn’t medically necessary for the achievement of the most important goals of breast reconstruction. Some women have chosen not to have further surgery to reconstruct the nipple after the major breast reconstruction work has been completed. Instead, for those women who prefer the look of a complete breast but do not wish to undergo anymore surgery, tattooing is a viable choice.
The type of breast reconstruction used for the nipple and areola is determined by taking into consideration the quality of tissue of the newly-constructed breast and whether or not the reconstructions will be done with a surrounding graft. In the past, one method used (if the other breast was still intact) was to excise a portion of that nipple and use it for the nipple of the new breast. However, there are concerns that the cells from the old nipple areola could potentially create new cancer cells in the newly-constructed breast. Another method is grafting tissue from the labia because the skin of the labia has a close resemblance to the pigmentation of the areola. Some disadvantages of using this method are it leaves an undesirable scar and there’s also the possibility that hair could grow from the graft.
The most common procedures done for reconstruction of the nipple and areola are either a flap, which consists of slices of tissue that are removed with their blood supply still connected; or grafts, which are slices of tissue that are disconnected from the surrounding blood supply, leaving the tissue reliant upon the blood supply source at the new area.
The methods called the Skate flap, C-V flap and Star flap are used to create the nipple by extracting skin or subcutaneous fat from the site surrounding the area of the new nipple and then sewing it together. Then a graft of skin from another area is used to create the areola.
Graft Nipple Reconstruction
The areas from which nipple grafts are taken and used for reconstruction are the labia and the nipple of the other breast if it’s still intact. When using the labia, a trilateral wedge is cut and grafted into position on the reconstructed breast.
Schedule a Consultation Today
Dr. Siamak Agha is a board certified plastic surgeon in Orange County and an experienced breast reconstruction surgeon. If you have lost one or both of your breasts due to illness or other trauma, learn more about your reconstructive options by calling Dr. Agha’s practice at 949-393-4213.