If the nipple is removed during a mastectomy, it can be reconstructed. This usually occurs during the final phase of breast reconstruction and can frequently be performed comfortably in the plastic and reconstructive surgeon's office.
Nipple reconstruction can be achieved using a CV flap, skate flap or double-opposing tab flap from the breast. These flaps of skin are rearranged to form a projecting nipple shape. Six to eight weeks later, a tattoo is used to color in the areola. This also effectively camouflages the scar that was created in making the nipple.
Alternative forms of nipple reconstruction include grafting part of the nipple from the other breast, placing a piece of ear cartilage or using a filler material such as fat to reconstruct the nipple or add projection to a previously reconstructed nipple that has flattened over time.
Nipple reconstruction takes 30 minutes for one nipple or 60 minutes for two nipples. Sutures are removed after 10 to 14 days. A protective dressing is worn for two to four weeks. Normal activity can resume in about 48 hours, except for vigorous exercise or heavy manual labor. Areola tatooing takes 30 to 45 minutes.
Common initial side effects include bruising and swelling. Because nipples tend to lose their bulk and projection over time, they are intentionally oversized during surgery. Delayed wound healing and infections may occur.