Nipple and Areola Reconstruction: Overview

The structure commonly referred to as a “nipple” is actually the nipple (center projecting part) and areola (surrounding pigmented part). For many women, nipple and areola reconstruction are the final surgical procedure of breast reconstruction. Nipple/areola reconstruction can be performed surgically or non-surgically.

What To Expect

In the pre-operative area, your surgeon will determine the optimal location for the nipple/areola reconstruction. Surgical nipple reconstruction involves folding of local skin flaps to create bulk and projection. The process is similar to origami, in which a flat piece of paper is folded into a 3-D form. The reconstructed nipple is based on soft tissues (skin and fat), and does not have a deeper supporting structure. Many nipple reconstructions lose projection (up to 50%) over time, and your surgeon may initially create a larger nipple to compensate for this expected outcome.

Nipple and Areola Reconstruction Procedure

Surgical areola creation requires a full-thickness skin graft, usually taken from somewhere else on your body. The graft is cut into a circle shape, and the nipple reconstruction can be brought through the central portion of the graft. The graft is set off visually by a having a different color and texture than the surrounding breast skin-much like a native nipple.

Before & After photo
Series showing (left) reconstruction of right and left breasts with DIEP flap,
Before & After photo
(center) reconstruction of nipple and
Before & After photo
(right) final result after tattoo of areola.

Nipple and Areola Reconstruction procedures can also be performed as followed. Non-surgical areola creation can be performed using a tattoo. Similar to the surgically created areola, a tattooed areola is visually distinct from the surrounding breast skin. A surgical nipple reconstruction (to provide depth) is commonly paired with a tattooed areola to create a final nipple/areola complex reconstruction.

Before & After photo
Before & After photo
Surgical creation of the left nipple with skin origami and areola with full thickness skin graft

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