Nipple reconstruction surgery
Nipple reconstruction surgery is a type of plastic surgery aimed at reconstructing the nipple and areola after they have been removed, typically as part of a mastectomy for breast cancer treatment. This procedure is often the final step in breast reconstruction and can significantly impact a patient's psychological recovery, helping to restore the breast's appearance and the patient's sense of wholeness.
Indications
Nipple reconstruction is indicated for individuals who have lost their nipple and areola due to surgery, trauma, or congenital anomalies. The most common reason for undergoing nipple reconstruction is following a mastectomy for the treatment of breast cancer. Patients who have undergone breast reconstruction and wish to achieve a more natural and symmetrical appearance may opt for this procedure.
Techniques
Several techniques are available for nipple reconstruction, each with its advantages and limitations. The choice of technique often depends on the patient's preferences, anatomy, and the specifics of their previous surgeries.
Nipple Sharing
Nipple sharing involves taking a portion of the patient's existing nipple (in cases where only one breast is affected) and grafting it onto the reconstructed breast. This technique is suitable for patients with sufficiently large and projecting nipples.
Local Flap Reconstruction
Local flap reconstruction uses the skin of the reconstructed breast to create a new nipple. Techniques such as the C-V flap or star flap involve cutting and lifting small portions of skin in specific patterns and folding them to form a nipple-like projection.
Medical Tattooing
Medical tattooing can be used alone or in conjunction with other techniques to add color and create the appearance of an areola. This non-surgical option involves injecting pigments into the skin to mimic the natural color of the nipple and areola.
Complications
As with any surgical procedure, nipple reconstruction carries risks, including infection, poor wound healing, and loss of nipple projection over time. Additionally, sensation in the reconstructed nipple is usually not restored to its original state.
Postoperative Care
Postoperative care is crucial for the success of nipple reconstruction. Patients are typically advised to wear soft, supportive garments and avoid pressure on the reconstructed nipple. Follow-up appointments are necessary to monitor healing and address any complications.
Psychological Impact
The psychological impact of nipple reconstruction can be profound. Restoring the appearance of the nipple and areola can help individuals feel more comfortable with their bodies and improve self-esteem and body image after breast cancer surgery.
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Contributors: Prab R. Tumpati, MD