This is a procedure that recreates or reconstructs an areola and a nipple in patients who have lost the nipple or who have congenital absence of the nipple. Typically though it is used in patients who have had breast reconstruction following mastectomy for breast cancer.
The surgery itself can take one to two hours depending on the technique used. Typically the nipple itself is recreated with a flap of local tissue on the reconstructed breast mound. This is called a skate flap and it involves moving flaps of tissue around to recreate a prominence that looks just like a nipple. The areola itself can then be reconstructed in a variety of ways. First, areola tissue from the contralateral normal side can be used to skin graft around the nipple thereby recreating a very realistic appearing made from the patient’s own areolar tissue but if that tissue is not available other skin grafts can be used such as from groin crease or from the labia. Easier ways to reconstruct very realistic appearing areola can be to tattoo the skin surrounding the nipple. This recreates an areola with a very good color match to the other side. These procedures can typically be done under local anesthesia or local anesthesia with sedation. Recovery is minimal. Patients may return to work typically after one to two days but should try to avoid any pressure or trauma to the breast area. Usually all sutures used are dissolvable and do not need to be removed.