For females with breast cancer, mastectomy is typically a required element of productive remedy. Even though surgical removal of a breast can avoid the spread of the illness and can be a crucial step toward a remedy, the emotional effects of mastectomy are not as constructive. To boost emotional wellbeing right after mastectomy and ease the transition toward wellness right after breast cancer survival, breast reconstruction has develop into a preferred solution. Breast reconstruction can build a constructive shift in the mindset and self-image of breast cancer survivors. Research have shown that the constructive effects of breast reconstruction are not completely realized with no reconstruction of the nipple and areola.

Nipple and areola reconstruction typically represent a mixture of surgical and non-surgical strategies. For instance, one particular of the mainstays of areola reconstruction is the use of tattoos for pigmentation. This non-surgical remedy is typically accompanied by surgical flap procedures for nipple reconstruction. With the numerous selections for reconstruction, the only way to create an optimal remedy program is to meticulously assess the patient's person anatomy and objectives, as properly as the status of their breast cancer. These components will decide which strategies of nipple and areola reconstruction will be made use of and when the process(s) will be performed.

Argument for Instant Nipple and Areola Reconstruction

Several surgeons really feel that nipple and areola reconstruction should really be delayed till right after breast reconstruction. Several California surgeons like myself will inform individuals that waiting till this point permits the reconstructed breast to settle into spot and may possibly make sure improved visual harmony in between the breast mound and the placement of the nipple-areola complicated. Nevertheless, in other instances, if females are told that they have to wait to pursue reconstruction of the nipple and areola, they will never ever total that stage of reconstruction. Several of these females have been exposed to surgery on several occasions and are reluctant to “go beneath the knife” however a further time.

Provided the constructive effects of nipple and areola reconstruction, there is a robust argument to be produced for performing every little thing doable to make sure that females do not miss this crucial final step, so numerous surgeons advocate for quick nipple reconstruction.

Nipple Reconstruction

  • Methods for reconstruction. Several surgeons use flaps of nearby tissue (i.e. star flap, skate flap, bell flap) to build a three-dimensional projecting nipple. Other surgeons use donor tissue (i.e. AlloDerm® Regenerative Tissue Matrix) and injectable fillers. Nevertheless other individuals use excess tissue throughout a key TRAM flap breast reconstruction process to right away build a projecting nipple.
  • Special considerations. Some females may possibly see a loss in nipple projection more than time – this is much less frequent with specific strategies of nipple reconstruction (some flap procedures) and is reversible with a secondary process.

Areola Reconstruction

  • Methods for reconstruction. Skin grafts from other physique regions can be made use of to build a reconstructed areola on the other hand, these procedures are overshadowed by enhanced tattoo procedures. Tattoos are a quite preferred approach of areola reconstruction and can be made use of to build definition and pigmentation.
  • Special considerations. If tattoos are made use of for areola reconstruction, some females may possibly see adjustments in pigment more than time. This is reversible with touch-up procedures.

Generating Symmetry

The presence of a nipple and areola on the healthier breast (contralateral) can either help or challenge the reconstructive surgeon. It can act as a all-natural template for the reconstructed nipple-areola complicated. Nevertheless, producing a reconstructed nipple and areola that are aesthetically identical – or at least largely comparable – and will continue to be aesthetically identical more than time can be a distinct challenge. There are various tools that an Orange County breast surgery specialist can use to build symmetry: areola reduction of the contralateral nipple, employing a tattoo pigment for the reconstructed nipple that is slightly darker than the contralateral nipple (to accommodate fading), and the creation of a reconstructed nipple that is initially slightly bigger than the ultimate optimal size (to accommodate the doable loss of size and projection).