Nipple Reconstruction Problems

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If you had a complication after nipple reconstruction or were not satisfied with your cosmetic results, you might have the option of redoing the nipple reconstruction or improving the color or position of the nipple(s).

These are some of the problems that can potentially be corrected:

Nipple flattening

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 became overly thinned when tissue removed during the mastectomy or from stretching from an underlying implant.

If your nipple flattened, your plastic surgeon may be able to redo the nipple reconstruction. Usually this will involve making small incisions, forming the tissue into a nipple shape and securing it with stiches, and adding a rolled-up piece of dermal matrix material, a graft of skin from another part of your body, or fat in the middle to help ensure the nipple will project out from the breast and reduce the risk that it will flatten again.

Tissue breakdown

When the tissue used to reconstruct the nipple doesn’t get enough blood, some of the tissue can die. This tissue breakdown is called “necrosis.” If this occurs, your plastic surgeon will have to trim away the dead tissue. If you have just a small amount of tissue necrosis — for example, if only the tip of the nipple is affected — then you might only need local wound care after the dead tissue has been removed. But if the tissue breakdown is more extensive, you may need to have the nipple removed. In most cases, you can opt to have the nipple reconstructed again.

Like the initial nipple reconstruction, a redo procedure will typically involve using some of the skin in the area where the nipple will be placed, a graft of skin from another part of your body, or dermal matrix material (a skin substitute made mostly of collagen) and creating the nipple through a series of incisions and tucks.

Inadequate pigment

Some women choose to have a nipple tattooed on a reconstructed breast instead of having the nipple rebuilt, and some choose to get a rebuilt nipple tattooed to add color. In either case, nipple tattoos often fade and need to be reapplied. If the pigment from a previous nipple tattoo is faded or is not the correct color, you can get a new tattoo.

It’s worth asking your medical team and doing research on your own to find someone who specializes in high-quality nipple tattooing to redo your tattoo.

Incorrect nipple location

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

In some cases, your plastic surgeon can reposition the nipple(s) on the breast. This involves making a series of incisions and moving the breast skin to reposition the nipple(s), as is done in a cosmetic breast lift procedure. The nipple(s) remain attached to the underlying skin.

Keep in mind that it may be easier for your plastic surgeon to move a native nipple than a reconstructed one. Also, it’s important to know that your plastic surgeon may not be able to move a reconstructed nipple that has already been tattooed.

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