Breast Reconstruction Surgery
Nipple and Areola Reconstruction
In general, the nipple and areola are removed during any mastectomy operation, because breast cancer can recur at those sites.
Some women who have breast reconstruction also choose to have the nipple and areola reconstructed. Most doctors prefer to wait several weeks or months after the first breast operation to rebuild the nipple and areola. This allows new breast tissue to heal and settle into place so minor adjustments, in size and position, can be made during the second procedure.
The nipple/areola reconstruction is typically an outpatient procedure performed under local anesthesia. Tissue for the nipple/areola is taken from the newly constructed breast. To match the color of the nipple of the other breast and to create the areola, medical tattooing is done at a later time.
The nipple may be temporary or permanent. The plastic surgeon makes a copy of the natural nipple and colors the areola. It can be adhered to the breast using prosthetic glue. It must be reglued every week or so.
What Happens After Breast Reconstruction Surgery?
Most women return to normal activities within six weeks after breast reconstruction surgery, but it may be several weeks before strenuous exercise can be performed.
After you go home, you can expect some soreness, swelling, and bruising for two to three weeks. You may be asked to apply medicines to the suture area or change bandages at home. Your plastic surgeon will advise you about bathing and wound care.
All soft-tissue surgery (the mastectomy and breast reconstruction) will leave areas of numbness where the surgery was performed. Instead of feeling pain where the tissue was taken, you may feel numbness and tightness. The same is true of the reconstruction site. In time, some feeling may return to the breasts. Most scars will fade over time.
Regular checkups will be required at first. If you have a temporary expander implanted, it will be expanded with saline once a week, on average, until the desired size is obtained (usually within six to 10 office visits). The shape of the reconstructed breast will gradually improve over the months following the reconstruction.
After breast reconstruction, breasts should still be examined every month. Many centers will not perform mammography on reconstructed breasts, however, so discuss screening procedures with your doctor.
Breast reconstruction has no bearing on cancer recurrence and generally does not interfere with chemotherapy. Radiation treatment usually is given before breast reconstruction.
A recurrence of cancer can still be treated by any of the standard treatment methods, which include surgery, radiation and chemotherapy. In addition, reconstruction rarely, if at all, hides or obscures a local recurrence of the cancer under or around the reconstructed breast.