Areola and nipple reconstruction
The strong points
- This is a precise surgery that allows to recreate the areola and the shape of the nipple
- We use an original technique that most often avoids the need for a skin graft or the removal of the contralateral nipple
- Areola reconstruction is the final step of a breast reconstruction that allows you to envisage your life without the disease
Reconstruction of the areola and nipple is one of the most important steps in breast reconstruction. Its surgical technique must be rigorous in order to obtain the most natural result possible. In most cases, we use the skate-flap technique. It consists of drawing 2 half areolas, one side of which will contain the future nipple. The two halves of the areola are then brought together towards the center and the hole left on the periphery is filled with a round-block. At the end of the procedure, the shape, volume and relief of the areola and nipple are restored. Only the color is missing and a tattoo of both areolas will be done 1 month later at the office.In rare cases, the skate-flap technique cannot be used. In rare cases, the skate flap technique cannot be used and we use a skin graft taken from the root of the thigh. Sometimes the reconstructed nipple is too small while the healthy nipple is very large. In this case, we graft half of the healthy contralateral nipple.
All areola and nipple reconstruction procedures are performed as outpatient surgery. Depending on the case, they are performed under local anesthesia with sedation (neurolepneumonia) or under general anesthesia. A pre-anesthetic consultation is necessary 48 hours before the procedure. Areola tattooing can be done at the office under local anesthesia or can be done in surgery. The skate flat technique is not painful and requires simple post-operative care. A work stoppage is not necessary. In the case of skin grafting, the surgery is slightly more painful and the post-operative care requires a 5 to 7 day break from work.
We have been using the skate-flat technique for 4 years and it has revolutionized our areola reconstructions. It avoids all the disadvantages of skin grafting (unsightly and sometimes painful scarring at the root of the thigh, hair growing on the areola and requiring electric hair removal). We use it almost systematically except in rare cases where the skin of the reconstructed breast is really too thin.
Questions / Answers
How long does it take to reconstruct the areola and nipple?
The areola and nipple can be reconstructed about 1 month after the breast volume reconstruction. However, in some cases where a breast reduction surgery is considered, it is preferable to wait 2 to 3 months after this procedure so that the areola on the healthy side takes its final position.
What is the post-operative care after areola and nipple reconstruction?
Post-operative care is relatively simple. They consist of a disinfection of the scar followed by the placement of compresses whose center has been perforated in order not to compress the new nipple. A Mepilex Border Flex dressing is then applied for 2 days to allow for a shower.
Is it possible to combine other procedures with areola and nipple reconstruction?
Yes, the reconstruction of the areola and nipple can be associated with a symmetrical plasty of the contralateral breast or a lipofilling (fat injection) to harmonize the reconstruction, especially in the neckline.
What is the cost of areola and nipple reconstruction?
The health insurance covers the reconstruction of the areola and the nipple. We charge additional fees that vary between 800 and 1200 euros depending on the technique used. In case of tattooing, 1 to 2 sessions are necessary and each session costs 400 euros.
Have a question? Please contact us!
Docteur Yaël Berdah and Docteur Marc-David Benjoar
Plastic surgeons in Paris France