Nipple and areola reconstruction

About the procedure

After reconstructing the breast with a DIEP flap, implant, or combination of techniques, there is a shaped breast mound but it doesn’t truly look like a breast until the nipple and areola have been reconstructed. Often, Los Angeles breast reconstruction patients will pursue nipple reconstruction as the final stage of breast reconstruction.  There are several different ways to reconstruct the nipple and areola, and most involve elevating existing breast tissue and constructing the form of a nipple. Commonly, a skin graft may be used to reconstruct the areola, or a tattoo can be used as well.

During the reconstruction of the nipple and areola, Dr. Hirsch will first draw the location of the nipple and areola on the breast and confirm the location with the patient. Next, he will elevate skin flaps and bring them together so that they are elevated above the breast skin in the shape of a nipple. He may then harvest a skin graft from the leg or groin to reconstruct the areola, although this can also be done with tattooing as well.

Nipple and areola reconstruction is usually performed on an outpatient basis so that patients can go home on the same day of surgery. In certain cases, it may even be performed in the office under local anesthesia. There is minimal downtime, and drains are not typically used during these procedures. Patients can often go back to work the following day after surgery.

A three dimensional tattoo can also be performed to help make the final result more natural, or even in place of a surgical reconstruction!

The video below demonstrates the nipple reconstruction technique.

Nipple reconstruction video

Frequently asked questions:

Is nipple and areola reconstruction covered by insurance?

Most major insurance plans cover nipple and areola reconstruction. Dr. Hirsch and his staff will work with you to help determine insurance coverage of these procedures.

What type of bra should I wear after nipple reconstruction?

For the first week after nipple reconstruction, you should not wear any bra so that you do not put any pressure on the new nipple.  After your procedure, Dr. Hirsch will place a padded gauze dressing on your nipple that he will remove when he sees you at his Sherman Oaks office.  After the dressing is removed, you should wear a soft bra with no underwire for the next 1-2 weeks.

Do I have to undergo general anesthesia for nipple reconstruction?

No, nipple reconstruction can be performed under sedation or even local anesthesia (injections only)!  When you meet with Dr. Hirsch, he will discuss possible choices for anesthesia for your nipple reconstruction.