Nipple Areola Reconstruction
The breast reconstruction process most often requires more than one surgery to achieve the final result. After the initial breast mound is created, these subsequent surgeries can work to refine the shape of the breast, improve symmetry, or restore normal breast characteristics such as the nipple and areola. Breast reconstruction patients from Washington, DC; Chevy Chase and Bethesda, MD; Arlington and Fairfax, VA; and beyond choose the experienced team at Center for Plastic Surgery for a variety of advanced cosmetic techniques.
Additionally, as new techniques are available to recreate a more natural-looking, aesthetically pleasing breast shape, women who underwent breast reconstruction in the past might need or wish to have revision surgery to improve the results of their original surgery.
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Nipple & Areolar Reconstruction
The majority of mastectomy patients who have breast reconstruction surgery also have nipple/areolar reconstruction. Nipple reconstruction gives the breast a natural appearance. It is a relatively simple procedure that is done on an outpatient basis under either sedation or a light general anesthetic. Nipple reconstruction may involve using local tissue from the reconstructed breast or sharing tissue from the opposite normal nipple. This tissue sharing procedure provides the best color and texture match with the opposite breast. It is necessary, however, for the patient to have adequate nipple tissue on the opposite breast and be willing to have the opposite nipple used.
The more common procedure is to create a nipple from a small flap of tissue on the reconstructed breast mound once the markings for the location have been completed. The areolar area (the pigmented skin surrounding the nipple) is reconstructed with a skin graft from one of several sites. Donor sites for areolar grafts will vary with each patient depending on color match and patient preference. Generally, a site that has some degree of color match with the opposite breast areolar area will be selected. The most common sources for the skin graft are the groin crease, the lower abdominal wall skin and, sometimes, the extra skin along the outside of the mastectomy scar.
Once the nipple/areolar reconstruction is completed and healed, the color match with the opposite breast will be reviewed. If the color match is not exact, as is usually the case, a simple in-office tattooing procedure can help gain the best color match. This tattooing is a relatively painless and simple procedure and, for some patients, may be substituted for the areola grafting procedure. Finally, in some patients, a small implant may be placed under the completed nipple/areolar reconstruction for additional projection.
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