Nipple-areola complex reconstruction puts the final aesthetic touch on breast reconstruction after skin-sparing mastectomy. While it is a completely individual decision, many patients choose to undergo nipple-areola complex reconstruction to complete their journey in battling breast cancer and reconstructing their naturally beautiful breasts.

Overview & Why Choose Dr. Chang

Nipple-Areola Complex Reconstruction

Patients Completely Healed After Reconstruction Following Skin-Sparing Mastectomies

Only patients who underwent skin-sparing mastectomies need nipple-areola complex reconstruction. Patients who have undergone implant-based or autologous breast reconstruction are equally good candidates.

Realistic Expectations

Dr. Chang views surgery as a partnership between the patient and him. It is important trust and confidence go both ways. Together, we will discuss your goals and if we can reasonably achieve those goals based on your anatomy.

Who Is a Candidate for Nipple-Areola Reconstruction?

Clinical photographs from multiple views will be taken of your breasts. These photos are used to plan for your individualized surgery and compare before and after surgery. No photographs will be published online without your written consent. 

Clinical Photographs

Dr. Chang will perform a physical examination of your breasts. This will include evaluation of your skin quality, the location of your prior incisions, the thickness of the soft tissue over your implants, and an assessment of the position and characteristics of the nipple-areolar complex for patients who underwent unilateral mastectomy and reconstruction.

Breast Examination

Pre-operative

Patients can alternatively choose to pursue medical professional tattooing of the entire nipple-areola complex. These tattoos can look very 3-dimensional but do not have actual tissue projection like a surgically reconstructed nipple.

Nipple-Areola Complex Medical Tattoo 

Patients who underwent surgical nipple reconstruction are referred to a medical tattoo professional to reconstruct the pigmented areola.

Areola Medical Tattoo

Under local anesthesia in the office, Dr. Chang uses your native breast skin to reconstruct a 3-dimensional nipple with projection. For most cases, the incisions are hidden in or extended from your previous mastectomy incisions.

Surgical Nipple Reconstruction

What Are the Options?

You will go home immediately after surgery. You may ambulate as much as tolerated. At 2 weeks, you may perform light cardio exercises. At 4 weeks, you may resume all physical activities.

Recovery Period

Local anesthetic (numbing medication) will be injected at your surgical sites to minimize your immediate post-operative pain. You should take acetaminophen and an NSAID as-needed for pain.

Pain Management and Medications

Your incisions will be dressed with surgical bandage strips and/or surgical skin glue. You may protect the surgical sites with gauze pads in a comfortable-fitting bra. You may shower the same day. Do not bathe or go swimming for 4 weeks.

Dressings and Incision Care

Post-operative

Loss of Projection

Because skin is designed to contract when cut, the projection of the surgically reconstructed nipple will decrease over time. Because of this, Dr. Chang creates an overly projected nipple at the time of reconstruction to account for the expected loss of projection.

Asymmetry

No one’s breasts are perfectly symmetric. While the goal is near-perfect symmetry, there will be some asymmetries in your reconstructed nipple position, shape, and size.

Need for Revision Surgery

Some patients may need revision surgery to address an aesthetic concern.

Unmet Expectations

Despite thorough pre-operative planning and discussions, you still may not be fully happy with your aesthetic results.

Poor Scarring

Everyone scars differently. The final scar takes 6-12 months to mature. In rare cases, hypertrophic scars or keloids may form and may require secondary revision.

Wound Healing Issues

There may be small areas where the incisions do not fully heal. In these cases, the wounds will be allowed to heal on their own with dressing changes. Severe cases may require a secondary revision procedure.

Infection

Infections are managed with antibiotics. In severe cases, you may need an additional procedure.

the Risks of Nipple-Areola Complex Reconstruction

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