When a woman has a mastectomy, the surgeon removes the whole breast, usually including the nipple and areola. Women who decide to have reconstruction after mastectomy also may choose to have their nipple reconstructed, too. Nipple reconstruction is done after the reconstructed breast has had time to heal – at least 3 or 4 months after reconstruction surgery.
There are several ways to rebuild a nipple:
- you can buy removable polyurethane nipples that you put on and take off as you like
- you can have nipple reconstruction using tissue from another part of your body, usually your chest wall or upper inner thigh
- you can have nipple reconstruction using a dermal matrix product (a skin substitute made mostly of collagen – AlloDerm, Strattice, NeoForm, and DermaMatrix are examples)
- you can get a nipple tattoo instead of using tissue to rebuild a nipple; some 3D nipple tattoos are amazingly realistic
Now, a small Dutch study has found that some women having mastectomy may want to bank their nipple so it can be attached later to their reconstructed breast. Still, women who banked their nipple had more medical complications. Nipple banking – also called nipple saving – involves removing the nipple from the breast and temporarily transplanting it to the groin area for about 9 months until reconstruction is complete.
The study “Breast reconstruction with nipple areola complex conservation and temporarily nipple banking: Does it outweigh the sexual costs?” was presented at the World Meeting on Sexual Medicine in Chicago on Aug. 28, 2012.
Nipple banking is more common in Europe than it is in the United States. Many U.S. surgeons don’t favor nipple banking because they believe the nipple can be injured by the way it’s stored. There also have been other complications with the surgery, including infection and cancer cells remaining in the nipple tissue.
Researchers in the Netherlands surveyed 318 women who were treated for breast cancer at a hospital in Amsterdam. Nipple banking has been offered at the hospital since 2005. Of these women:
- 18% had nipple banking
- 53% had a nipple tattoo
- 29% didn’t have reconstruction
The survey asked the women about their anxiety levels, social support, social functioning, cancer worry, body image, and satisfaction with their breast after cancer surgery and reconstruction (if they had reconstruction).
There were no differences in any of those survey areas between the three groups of women.
But there was a large difference in the number of women who had medical complications:
- 40% of the women who had nipple banking had complications
- 17% of the women who had a nipple tattoo had complications
The women who had nipple banking also were less sexually active. About 66% of the women who had nipple banking said they weren’t having sex or were having less sex because they were embarrassed or felt discomfort while their nipples were being stored in their groin.
Keeping something of their own breast was much more important to the women who had nipple banking (77%) compared to women who had nipple tattooing (15%).
Overall, the women who had nipple banking said they were satisfied with the experience and would recommend it to other women.
Whatever your age, marital status, sexual activity or orientation, you can't predict how you will react to losing a breast. It’s very normal to feel anxious, uncertain, sad, and mournful about giving up a part of your body. If keeping something of your own breast is very important to you, you may want to talk to your oncologist and your surgeon about nipple banking and whether it’s a possibility for you. Nipple banking isn’t available everywhere; cancer centers in large cities and cancer centers affiliated with universities are more likely to have surgeons experienced with the procedure. Together, you and your doctors can develop a reconstruction plan that’s right for you and your unique situation.