Nipple Reconstruction
Also known as: nipple restoration
Nipple reconstruction surgery is a special procedure to recreate the nipple and areola on a reconstructed breast, usually after a mastectomy or other breast surgery for cancer.
What is nipple reconstruction surgery?
Nipple reconstruction surgery is a special procedure to recreate the nipple and areola on a reconstructed breast, usually after a mastectomy or other breast surgery for cancer. This surgery aims to restore the natural shape and contour of the breast by creating a new nipple using tissue flaps or grafts, often with medical tattooing to match the colour and texture of the areola. It’s usually done as the final stage of breast reconstruction and can make a big difference to the aesthetic outcome and well-being of the patient. The procedure is relatively minor, usually done as a day case under local anaesthetic, and most people return to normal activities within a few weeks.
Reconstruction options
Surgical procedure
Surgical nipple reconstruction involves creating a new nipple using tissue from the reconstructed breast. The procedure is performed under local anaesthesia (sometimes general anaesthesia) and takes approximately 30 minutes to an hour. The surgeon will mark the position of the new nipple on the breast skin and use a skin flap to create the nipple shape. The areola is most often recreated later with medical tattooing to match the colour. Skin grafts from another site, such as the inner thigh, may be used occasionally but are less common.
Tattooing of the nipple areola complex
Tattooing of the nipple areola complex is a non-surgical option that involves applying ink to the skin to create the areola colour. This can be done as a standalone procedure or in conjunction with surgical nipple reconstruction. Modern 3-D tattooing can look very natural and is often chosen as the only procedure, especially when radiotherapy or thin skin makes surgical flaps less reliable.
Prosthetics
An alternative to surgical reconstruction or tattooing is the use of stick-on prosthetic nipples, which are custom-made to match the patient’s original nipple and areola. They can be worn as desired and removed when not needed.
Please call to enquire about the price
Ways to payBefore surgery
Initial consultation
During your consultation, your breast surgeon will discuss the procedure, including its associated risks and benefits. This is an excellent opportunity to ask any questions you may have. A breast care nurse will be available to support you, answer any concerns and guide recovery and related procedures.
Your surgeon will assess the condition of the breast mound and skin to determine the best time for the procedure, usually after the breast mound reconstruction has fully healed. The surgical site must be free from infection, and any postoperative swelling must have subsided before proceeding. If you’ve had radiotherapy, many surgeons delay or recommend tattoo-only reconstruction due to the healing risks.
Preparing for surgery
Preparing for nipple reconstruction surgery involves several essential steps to get the best possible outcome and minimise risks.
You may be advised to stop taking certain medications, such as blood thinners, that could increase the risk of bleeding during surgery. Smoking cessation is also highly recommended as smoking can delay wound healing and increase the risk of complications.
On the day of surgery, you will meet the nursing team, who will assist with pre-operative preparations, including reviewing your medical history. You must read and sign the consent form before the operation to make sure you fully understand all aspects of the surgery.
During surgery
In nipple reconstruction surgery, the surgeon creates a new nipple using a small flap of skin from the reconstructed breast. In rare cases, a skin graft from another area of the body (such as the inner thigh) may be used, but this is much less common. This skin is lifted, shaped, and stitched to form a nipple with natural projection and contour. Careful planning goes into placing the nipple so that it lines up with the opposite breast and looks as symmetrical as possible.
The procedure usually takes 30-60 minutes and is most often performed under local anaesthesia, although general anaesthesia may be used in some cases, depending on your health and preferences. The surgeon preserves the blood supply to the new nipple to support healing and reduce the risk of tissue loss.
At the end of surgery, the incision is closed with delicate stitches. These may dissolve on their own or be removed at a follow-up visit. Some light oozing or bleeding from the surgical site can occur immediately after the procedure. This is normal and will be checked and managed by your care team.
The areola is usually added later with medical tattooing, which can create a natural appearance and realistic colour once the nipple has healed.
After surgery
Immediate post-surgery care
Post-operative care is key to a successful recovery after nipple reconstruction. During the first few days after surgery, you must monitor for swelling and severe pain as these can be signs of complications.
You will need to keep the surgical area clean and dry to prevent infection and aid healing. If you notice any signs of infection, such as changes in colour, severe pain, or swelling, contact your breast care nurse for advice. Avoid pressure on the new nipple from tight bras or clothing during early healing.
Long-term recovery
The time frame for healing after nipple reconstruction surgery can vary, but most patients can expect significant improvement within a few weeks. You must attend follow-up appointments, usually one week after the operation, to assess the wound’s healing and to remove the dressing. During this time, you should be aware of potential risks that could impact wound healing and take steps to optimise the recovery process.
Using a moisturising cream can be very helpful in aiding the healing process and minimising scarring. Massaging the cream into the affected area after the dressing is removed can help the overall outcome.
The reconstructed nipple may be prominent and swollen initially, but this usually settles down within a few weeks. It’s normal for the reconstructed nipple to lose some projection over time. Many surgeons recommend tattooing several months after the initial procedure to improve the overall appearance.
Appointment and Treatment Plan
Initial Consultation
Your surgeon explains the procedure, discusses risks and benefits, checks that the breast mound has healed and swelling has settled, and advises on timing, especially if you have had radiotherapy.
Preparation
You may need to stop certain medications, avoid smoking, and sign a consent form on the day of surgery after your health is reviewed by the nursing team.
Surgery
Usually under local anaesthesia, the surgeon creates a nipple using skin from the reconstructed breast, sometimes with a graft, places it for symmetry, and closes with fine stitches; the procedure takes 30-60 minutes, and the areola is usually added later by tattooing.
Immediate Post-surgery Care
You keep the area clean and dry, avoid pressure from clothing, and watch for swelling, pain, or infection, contacting your nurse if problems occur.
Long-term Recovery
Healing improves within weeks, with follow-up visits to check progress and remove dressings; moisturising and massage help reduce scarring, projection often softens over time, and tattooing can enhance the final appearance.
Experts
We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.
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FAQs
Yes, you can reconstruct a nipple after breast reconstruction surgery. This is often the final stage in the breast reconstruction process to create a natural-looking nipple and areola to match the reconstructed breast. Options include surgical flaps from breast skin, tattooing, or both. The choice of method depends on the patient’s preference, the condition of the breast skin and the surgeon’s recommendation. It’s essential to discuss these options with a qualified surgeon to determine the best approach for the desired nipple shape and projection.
The cost of nipple reconstruction can vary greatly depending on the complexity of the procedure, the location of the surgery and if it’s done in conjunction with other breast reconstruction surgeries. In some cases, health insurance may cover nipple reconstruction as part of breast reconstruction, but patients should check with their insurance provider.
Most reconstructed nipples have little or no feeling. Some patients regain some light touch on the skin, but erotic or breastfeeding function is not restored. The amount of feeling can vary depending on the individual’s healing and the surgical technique used. Surgeons aim to position the new nipple and areola complex to achieve the best aesthetic results while considering the potential for feeling. Patients should discuss their expectations and any concerns with their surgeon during the consultation phase to get a complete understanding of the procedure’s outcome.