Further operations and nipple reconstruction
The aim of such adjustments is to further improve the size and shape match of the breasts. These are usually more minor operations than the first one. Various adjustments are carried out and these include:
• Inserting or exchanging a breast implant to improve the shape or size match
• Reducing or reshaping your opposite breast to match the reconstructed breast
• Reducing the size of or reshaping a flap reconstruction
• Adding fat to your reconstructed breast using fat graft or lipomodelling
Lipomodelling is a relatively new technique where fat is removed by liposuction, refined and then transferred to another area with a special grafting tube (“cannula”) to add volume and thus increase size and improve shape and profile. It has proved particularly useful as an adjunct to breast reconstruction:
• Fat is taken from an area where there is plenty, such as the hips or tummy
• It can then be used either to increase the size of a previous reconstruction or correct a contour dip on the breast or chest
• It is a relatively non-invasive procedure and can be done on its own or at the same time as other adjustments
• Either local or general anaesthetic can be used depending on the size of the area to be treated
• Lipomodelling may need to be repeated if the first treatment does not fully correct the problem
Sometimes these operations will be combined with nipple reconstruction
In spite of the breast mound being there, you may not think it looks like a breast until there is a nipple and some pigmentation around it. Nipple reconstruction is usually done at a later stage following reconstruction of the breast.
The reason for the wait is to allow the swelling in the reconstructed breast to settle down and the breast mound to become supple. This allows for more accurate placement of the nipple in comparison with the opposite natural breast. If you are having any radiotherapy or chemotherapy, then the plastic surgeon will usually allow at least three months from the time of completion of this before performing the nipple reconstruction.
If you decide to have a nipple reconstruction, it’s important to be realistic about what the surgery can offer. It will restore the look, but not the feel or sensation of the nipple. The nipple which is reconstructed may also flatten a little over a period of time.
Nipple reconstruction is usually done awake, using local anaesthesia. There are two main methods of nipple reconstruction:
• Either flaps of tissue are raised up on the reconstructed breast and sewn together to make a nipple shape;
• Or a portion of the opposite nipple is transferred to the reconstructed breast. At a further separate stage a tattoo is applied of appropriate colour to mimic the areola. Some women choose to have this without nipple reconstruction. This is a simple outpatient procedure.
If you choose not to have a permanent reconstruction, you can be supplied with a stick-on nipple prosthesis (an artificial body part) made from silicone rubber, matched to the other side
Introduction to breast reconstruction
When to have breast reconstruction
Operations to make a new breast
Reconstruction in other situations
Where can you have breast reconstruction?
Other questions and where to get more information