How do surgeons reconstruct the nipple and areola?

How do surgeons reconstruct the nipple and areola?

After the chest heals from reconstruction surgery and the position of the breast mound on the chest wall has had time to stabilize, the nipple and areola can be reconstructed. This can be done in two ways—surgically or with tattoos.

For surgical nipple reconstruction, the new nipple is created by cutting and moving small pieces of skin from the reconstructed breast to the nipple site and shaping them into a new nipple. A few months later, the surgeon can re-create the areola. This is usually done using tattoo ink.

However, in some cases, skin grafts may be taken from the groin or abdomen and attached to the breast to create an areola at the time of the nipple reconstruction (1).

Alternatively, a new nipple and areola can be created by a tattoo artist who specializes in 3-D nipple tattooing. Such a nipple is flat to the touch but looks realistic.

A mastectomy that preserves a woman's own nipple and areola, called nipple-sparing mastectomy, may be an option for some women, depending on the size and location of the breast cancer and the shape and size of the breasts (4, 5).