What to Expect on the Day of Nipple Reconstruction Surgery
On the day of your Nipple Reconstruction surgery, Dr. Papanicolaou will draw markings on your breast to show where the incisions will be made, and if a skin graft is being performed, the other area of your body that is being removed. You’ll probably be standing up while this happens.
Next, you will be sedated so you have a more comfortable and painless experience. This procedure typically uses a local anesthetic, which means you will be awake. If the skin is being taken from another place on your body to reconstruct the nipple, that area will be numbed with a local anesthetic, and you should be administered general anesthesia.
There are several types of techniques that Dr. Papanicolaou can use for Nipple Reconstruction and will be discussed during your consultation. Some of these techniques include:
- Building a new nipple with the surrounding skin: The most common approach, this technique requires the skin from around your breast where the nipple should be. Dr. Papanicolaou makes a few small incisions and forms the tissue into a nipple shape, then secures it with stitches. An areola can also be created later with tattooing if this is something you are interested in.
- Creating the new nipple with surrounding skin and an areola with a skin graft: Much like the aforementioned technique, Dr. Papanicolaou uses skin from the area on the breast where the new nipple will be located to form its shape. Then, to create the areola, skin from another part of your body is used, like the edge of a healed mastectomy or C-section scar or from some loose skin on the lower belly, and that is grafted into place. Only a small amount of skin is needed to recreate the nipple.
- Nipple sharing: If you have a mastectomy on only one breast and the nipple on the other breast is large enough, Dr. Papanicolaou can take a portion of the remaining nipple, using it to build a new nipple on the reconstructed breast. This approach makes it easier to match the new nipple with the natural nipple in size, color, and position.
No matter which technique is used, Dr. Papanicolaou will usually try to create a reconstructed nipple that is larger than the final desired size which will compensate for the eventual flattening of the reconstructed over time.
Once finished, a nipple shield (a tiny hat-shaped protective covering with a wide flat brim) or other protective dressing is taped over the reconstructed nipple, with antibacterial ointment used to prevent infection.
The length of Nipple Reconstruction can take up to 2 hours.
Nipple Reconstruction Recovery
You will typically be allowed to return home after you have been released by Dr. Papanicolaou. In certain instances, patients may be required to stay at the hospital overnight if they are having additional surgery, but you can discuss your options during the consultation. Before you leave, you will be given specific instructions to follow during recovery, as well as how to care for the protective dressing and stitches. This protective dressing is encouraged to be left on for about three days to a week. Once it’s been removed, you will be able to shower again.
You probably won’t feel much pain or tenderness in the nipple area after surgery due to the lack of sensation in your breasts after a mastectomy. You will likely feel tender and mild pain for a week or two if the skin is grafted from another part of your body. Dr. Papanicolaou should prescribe you some temporary medications that will help ease any pain you may have.
Initially during recovery, your new nipple(s) may look larger and more pointed than you anticipated, and they will be red, and swollen, and there will be visible incisions. As your nipple(s) heal, they will start to shrink and look more like you expected.
If you are considering having tattoos applied around your new nipple, you will need to wait between four to six months after your surgery so they can properly heal. Many patients use tattooing to add color and make them appear more realistic.