How Do You Make a Nipple?
Nipple reconstruction is usually a part of the final stage of breast reconstruction. A nipple reconstruction can be done as an office procedure, but sometimes is incorporated with revision of the reconstruction in the operating room. In our practice we perform the nipple reconstruction, and then tattooing of the areola as a separate procedure.
In simple terms, the nipple is made from elevating skin and folding it in a way that leaves a ‘nub’ of skin that looks like a nipple. In medical terms we refer to the skin elevation as “elevating a flap”, and the flaps described for nipple reconstruction are numerous. We may use a different flap design based on the needed size, width, or projection – either to match the other side (for one–sided reconstruction) or based on the patient’s goals (for two–sided reconstruction). Importantly, though the final product may strongly resemble an actual nipple, the reconstructed nipple does not have sensation or ability to change with temperature changes, and lacks erogenous sensation.
You can also watch the following 9 min video to see the specific steps involved in a nipple reconstruction done in the office.
FAQs
Nipple reconstruction is generally considered the final phase of the overall breast reconstruction process. It is often scheduled after the primary reconstruction has healed and settled.
Yes, in many cases this procedure can be completed in a clinical office setting. However, depending on the patient’s individual circumstances, it may also be performed in an operating room alongside other reconstructive revisions.
The two procedures are typically handled separately. Nipple reconstruction is completed first, and areola tattooing is scheduled as a follow-up appointment after healing.
No donor tissue from another part of the body is required. The nipple is formed using the patient’s existing local skin, which is lifted and shaped to create a natural-looking projection.
Not necessarily. The specific technique chosen depends on factors like the desired size, shape, and projection of the nipple as well as whether reconstruction is being done on one or both sides.
The cosmetic result can closely resemble a natural nipple in appearance, especially once the areola tattoo is added. However, it is a surgical construct and will differ in some functional ways.
Unlike a natural nipple, a reconstructed one will not have normal sensation, will not respond to temperature changes, and will not have erogenous sensitivity. Patients should have realistic expectations about these functional limitations before proceeding.