Nipple reconstruction is often the final stage in reconstruction of the post-mastectomy breast defect. Many patients following mastectomy will be candidates for nipple reconstruction. Under most circumstances, the nipple and areola are removed during mastectomy for treatment of breast cancer. The nipple is removed during mastectomy due to ductal breast tissue contained within the nipple. A select group of patients may be candidates for nipple or areola sparing mastectomy but these determinations will be decided by tumor type and location. The nipple is often reconstructed using skin contained within the breast.
Following reconstruction of the nipple patients may decide to undergo tattooing of the aureola to provide pigmentation and further reconstruct features of the breast following mastectomy.
During breast reconstruction, it is best to wait until the end of the process to finalize the location and size of the nipple, especially when trying to match to the opposite breast. The main reason being that as the reconstructed breast mound heals, it takes a few months to achieve its final shape.
The new nipple location is marked and the nipple is created using skin contained within the breast. If a flap has been used for reconstruction of the breast mound, then there is surrounding extra skin to build a nipple along with surrounding areola.