There are a number of surgical techniques that can be used to replace a nipple that has had to be removed along with breast tissue in a mastectomy procedure. Here is a short list of some of the main techniques...
Many patients opt for the relatively straightforward technique of simply tattooing a nipple on the reconstructed breast to match the nipple position and colour on the other breast. Although this will have a similar look to a natural nipple, it will not have either the profile or the sensation of a natural nipple, although it may be possible to give the tattoo a 3D effect to make it look more natural. Medical tattooing can be also be used in conjunction with other nipple reconstruction techniques.
This is where a false nipple is attached to the reconstructed breast with special glue. Although the nipple will have a better profile than a tattoo, it will also not have any sensation or feeling.
Nipple Reconstruction Surgery
The aim of nipple reconstruction is surgery is to match as closely as possible the look of the original nipple (and surrounding areola) in terms of size, position, shape, texture and colour. This skin graft procedure can use tissue from the breast itself, or the opposite nipple or in some cases tissue from elsewhere such as the ear, eyelid, inner thigh or buttocks. A relatively new technique is to use 'donor skin' (where the cells have been removed) to construct a new nipple.
Nipple Sparing Procedure
This is not technically a nipple reconstruction, but is a technique used during a mastectomy where the nipple itself is not removed, although tissue underneath it is removed. This is not always possible, depending on the location of the tumour. If it is close to the nipple then nipple sparing will not be possible. Also blood supply to the remaining nipple may be affected, as well as nerve connection, so the remaining nipple is unlikely to have any sensation.
It is recommended that any nipple reconstruction surgery is delayed until several months (normally 3-4 months) after the original breast reconstruction surgery, to allow the breast tissue to heal and the breast to 'settle' into position, so that the reconstructed nipple can be placed in the most natural position.
Nipple reconstruction can generally be carried out under local anaesthetic as an outpatient procedure.