What is nipple reconstruction after mastectomy ?
Nipple reconstruction is a surgical procedure that is usually performed after a mastectomy (removal of the breast). This procedure aims to create a new nipple and an area of areola around the nipple to restore the natural appearance of the breast. Reconstruction can be done as part of a full breast reconstruction or as a stand-alone procedure.
What are the criteria for being a candidate ?
The criteria for being a candidate for nipple reconstruction after mastectomy vary depending on each person's preferences and the options available for reconstruction.
However, general criteria that may influence the decision to proceed with nipple reconstruction include:
The skin at the mastectomy site should be soft and elastic enough to allow for nipple reconstruction
An absence of cancer in the treated breast for at least two years
An absence of medical conditions that could affect wound healing or healing, including autoimmune disease or an infection
An absence of smoking or prolonged use of any type of tobacco product
Patient must be in good overall health and able to undergo surgery
What is the difference between nipple reconstruction and breast reconstruction after mastectomy ?
Nipple reconstruction and breast reconstruction are two separate procedures, often done together as part of breast reconstruction after a mastectomy. Here is the difference between the two:
Breast reconstruction: Breast reconstruction is a surgical procedure to restore the shape, volume and appearance of the breast after a mastectomy. It aims to completely reconstruct the breast, using different techniques such as breast implants or flaps of tissue taken from other parts of the body. The objective is to recreate a symmetrical and natural breast.
Nipple reconstruction: Nipple reconstruction is a specific procedure aimed at recreating the nipple and the areola, the pigmented area around the nipple. This procedure is usually performed after breast reconstruction, as it finalizes the appearance of the reconstructed breast. Nipple reconstruction can be performed using skin grafting techniques, medical tattooing, or a combination of both, to recreate a nipple of the appropriate size, shape, and color.
In summary, breast reconstruction aims to restore the entire breast after a mastectomy, while nipple reconstruction focuses specifically on creating the nipple and areola. The two procedures are often performed together to achieve a full and natural result after mastectomy.
Is it painful ?
Nipple reconstruction after a mastectomy is generally well tolerated and the pain associated with the procedure is often mild to moderate. However, each person reacts to pain differently and the perception of pain can vary from individual to individual.
Here are some things to consider regarding pain related to nipple reconstruction after mastectomy:
Anesthesia: Before the nipple reconstruction procedure, local anesthesia is usually given to numb the treated area. This helps minimize discomfort during the procedure.
Individual Sensitivity: Each person has a different sensitivity to pain. Some people may experience mild discomfort, pressure, or transient pain during and after the nipple reconstruction procedure. However, the associated pain is usually well controlled with pain medication prescribed by your surgeon.
Postoperative Recovery: After nipple reconstruction, you may experience some tenderness, mild pain or discomfort in the nipple area. treated area during the recovery period. Your surgeon will usually prescribe appropriate pain medications and provide guidelines for managing postoperative pain and discomfort.
What types of techniques are used ?
There are several techniques used for nipple reconstruction after a mastectomy. The choice of technique will depend on various factors, such as the individual characteristics of the patient and the preferences of the surgeon. Here are some of the commonly used techniques:
Skin grafting: This technique involves taking skin from another part of the body, usually from the groin or inguinal region, and transplanting it to the area of the reconstructed nipple. Skin grafting recreates the projection and texture of the nipple.
Local flap: In this technique, a flap of skin is taken from near the area of the reconstructed nipple, usually from the breast itself or surrounding tissue. The flap is reshaped and replaced to form the nipple.
Medical tattooing: Medical tattooing, also known as dermopigmentation, is a technique where pigments are injected into the skin to recreate the areola and give a realistic appearance to the nipple. This technique is often used in combination with other reconstruction methods.
Composite reconstruction: This technique combines skin grafting and medical tattooing. A skin graft is performed to form the nipple, then a medical tattoo is performed to add color and detail to the areola.
How is the surgery performed ?
Nipple reconstruction after a mastectomy is usually performed as part of overall breast reconstruction. Here are the general steps of the nipple reconstruction process:
Preoperative consultation: You will meet with your plastic surgeon to discuss your expectations, goals and to plan the nipple reconstruction . Your surgeon will also review your overall medical situation and discuss the various reconstruction options available.
Surgical preparation: Before surgery, you will be prepared according to the chosen reconstruction technique. This may include a shave of the skin donor area or preparations for skin grafting.
Anesthesia: Prior to surgery, you will be given local or general anesthesia to ensure you are comfortable and painless during the procedure.
Nipple Reconstruction: Depending on the chosen technique, nipple reconstruction may involve skin grafting, local flap or a combination of techniques. Your surgeon will sculpt the skin and reshape it to recreate the projection and shape of the nipple. The nipple can also be pigmented with a medical tattoo to recreate the areola.
Sutures and Bandages: After the nipple reconstruction is complete, sutures will be used to close the incisions. Bandages will be applied to protect the treated area and promote healing.
Post-operative recovery: After surgery, you will be monitored in a recovery room for a short time. Your surgeon will give you postoperative instructions, including wound care, medications to take, and activities to avoid.
Follow-up and adjustments: Follow-up visits will be scheduled with your plastic surgeon to monitor your progress, remove sutures if necessary and make aesthetic adjustments if needed.
How long does it take to recover ?
The recovery period after nipple reconstruction after mastectomy can vary from person to person depending on several factors, such as the reconstruction technique used, the complexity of the procedure, individual reaction to treatment, and recommendations. specific to your surgeon. Here is a general estimate of the payback period:
Immediately after surgery: After nipple reconstruction, you will usually spend some time in the recovery room to recover anesthesia. Your surgeon may apply bandages to the treated area to protect the wound and promote healing.
Early days: You may experience some pain, swelling, and discomfort in the area of the reconstructed nipple. Your surgeon will prescribe pain medication to manage the pain. It is recommended to rest and avoid intense physical activities during this period.
First weeks: During the first few weeks after surgery, you will need to take care of the wound according to your doctor's instructions. surgeon. It may be necessary to wear special dressings to protect the treated area. Bruising and swelling may gradually decrease.
Daily Activities: You may gradually resume your normal daily activities as recommended by your surgeon. This may include restrictions on movement or activity that could affect the reconstructed nipple area.
Full recovery: The full recovery period usually ranges from a few weeks to a few months. Over time, scar tissue will grow and the reconstructed nipple area will heal. Follow-up visits with your surgeon will be important to monitor healing and make any necessary adjustments.
What are the expected results ?
Expected results of nipple reconstruction after mastectomy can vary depending on the technique used and each person's preferences. In general, nipple reconstruction can help restore the natural appearance of the breast and improve self-esteem. The reconstructed nipple may be smaller than the original nipple and may not be exactly the same color, but surgeons strive to create as realistic an appearance as possible. Sensation in the reconstructed nipple may be reduced or absent, but this depends on the method used to reconstruct the nipple. Ultimately, the expected results of nipple reconstruction vary from person to person and can be influenced by several factors such as age, tissue quality, previous radiation therapy, and personal expectations.