Nipple Reconstruction Problems

If you have a complication after nipple reconstruction surgery or are not satisfied with the cosmetic results, you might be a candidate for corrective surgical and non-surgical techniques. Possible complications of nipple reconstruction include nipple necrosis, nipple flattening, inadequate pigment, and incorrect nipple location.

In some instances, a reconstructed nipple may flatten out more than expected after a nipple reconstruction procedure. When this happens, it’s often because the breast skin becomes overly thinned when tissue is removed during the mastectomy or because of internal pressure from an implant that is stretching it out too much. A reconstructed nipple may also flatten out more than expected because of external pressure from bras and clothing.

If your reconstructed nipple flattens too much, you may choose to redo your reconstruction surgery to fix the nipple reconstruction failure.

Surgery usually involves making small incisions, forming the tissue into a nipple shape, and securing it with stitches. Surgeons also add a rolled-up piece of dermal matrix material (a type of surgical mesh), a graft of skin from another part of your body, or fat in the middle to help the nipple project out from the breast. Your surgeon may create a larger nipple on purpose to allow for shrinkage.

If you don’t want surgery again, you can choose not to reconstruct your nipples at all and instead consider prosthetic nipples or getting nipple tattoos.

Nipple reconstruction failure can also happen when the tissue used to reconstruct the nipple doesn’t get enough blood and oxygen and the tissue dies. This tissue breakdown is called necrosis. If you have nipple necrosis, your surgeon has to remove the dead nipple. 

If only the tip of the nipple is affected by necrosis, you might only need local wound care after your surgeon removes the dead tissue.

If you have nipple reconstruction surgery, you have the option of having the reconstructed nipple tattooed to add color. Ink fades after some time and needs to be reapplied. If the ink fades too much or is not the right color, you can get a new tattoo.

Ask your care team to recommend someone who specializes in high-quality nipple tattooing.

Sometimes after breast reconstruction surgery one or both nipples are off-center or otherwise not in the correct position. This can happen whether your nipples are reconstructed or not.

In some cases, surgeons can fix a nipple’s position on the breast by making a series of incisions and moving the breast skin to reposition the nipple, as they do during cosmetic breast lift procedures. The nipple remains attached to the underlying skin.

It might be a little more challenging for surgeons to move a reconstructed nipple. A surgeon also might not be able to move a reconstructed nipple that has already been tattooed.