Nipple reconstruction

I am considering nipple reconstruction once my recon is complete.
Can any ladies who have had this already let me know at what stage is this done and where did they take skin from to reconstruct nipple.
I had delayed LD recon without implant Oct 2011 and am having about 3 fat filler procedures.
Will they do nipple recon at the same time as a reduction and lift on the ‘good’ side?
Jude

oh my word!! thats a good question Jude,and something im going to have to consider soon but i never ever dreamed it would be labial skin,think i will give it a miss!!!
Di.x

I have just had nipple recon done. Mine was done alongside uplift and slight reduction on good side and revision on diep recon with slight liposuction. No mine was not labial skin! I wouldn’t have even considered that option! Mine was created out of the flap skin - a little arrow shape and as revcat says sort of twisted into shape or as a friend of mine says skin origami. My main fear was that it would be too big as I know they like to allow for shrinkage but I am very pleased with the final outcome. I go back to the plastic surgeon in three months when I hope to be referred for tattooing.
Ps Revcat, I was on the waiting list for eight months for diep and then a further eight months for the matching up op.
Pam x

Hi Jude,
Like everything else this seesm to vary a lot from place to place, and depends on individual surgeons preferneces and waiting lists.

I was formally referred for symmetry surgery last November and *may* finally get my symmetry procedure this August or September (so much for the 3-4 month waiting list I was told about). I was told that they like to wait a further six months after symmetry surgery before doing a nipple recon as this gives a better matched result. To be honest, I’m not sure I will bother with nipple recon - I’ve got so used to what I look like now. But you mustn’t let my view sway you.

I know some hospitals do both procedures at the same time.

In terms of how they do it, it varies. here are three I am aware of. (1) Some do nipple sharing, where they take part of your healthy nipple and move it to the recon breast. (2) Some use labial skin (makes my eyes water just thinking of it!) as it is a good colour match. (3) Some cut a little t-shaped flap of skin from the recon breast and fold it round to make a nipple shape (lots of you tube videos of this approach, this is the one my lot do, under local anaesthtic, evidently it takes about an hour). Then at some later date they offer tattooing of the nipple/areola to look more realistic. I am told that the tattooes last about two years, and that often the recon nipples have gone totally flat in that time too. However, I have also been told that they can re-tattoo if you wish.

Hope you get the info you need, but I think your best bet is to speak to your own team to see what they say.

(Just editted this to make it a bit clearer an dit has fallen to the bottom of the thread… this new site seems to see edited posts as new ones, which confuses the conversation somewhat! Ho hum)

Hi

Another option. My surgeon uses skin from the top of the thigh on th inside - where it;s darker and then doesn’t tattoo.

Dx

I’m having my nipple recon done next Thursday (using flap skin), together with some lipofilling to even out my cleavage. I’m glad you are pleased with the results Pam. I keep wondering if I need to put myself through more surgery, but then again it’s the last bit to get back to being as normal as possible.
Et

I had an immediate DIEP reconstruction in January, and was told in May that I may have to wait up to a year for my nipple reconstruction, removal of my dog ears, and liposuction. I was surprised to get a call about three weeks ago to say there was a chance it could be done during the summer, and even more amazed to then be offered a cancellation about 10 days ago. My nipple was reconstructed by cutting a clover-shaped piece from the flap skin on my boob and folding it round to make a nipple shape. Apparently they don’t cut through all the layers of skin, so that the area which has been cut isn’t completely raw. It was kept covered in a foam dressing for the first week, and when I saw the finished result on Friday, I couldn’t believe how good it looks. I also had liposuction from my reconstructed boob, but there is still a bit of swelling, so I can’t tell how well matched it is to my good boob now. I was fortunate in that the reconstructed boob has dropped to match the other side perfectly.
I also had my dog ears removed, and general liposuction around my hip area. When the surgeon removed the dog ears, she opened up the last 2-3 inches of the original DIEP scar, so it is now very neat and tidy, with no additional scarring. I couldn’t believe the amount of bruising from the liposuction, but none of the procedures were particularly painful. I think the whole thing took about 1.5 hours. I should have the tattooing done in about 6 weeks.
When I was first told that I needed a mastectomy in November, I never would have dreamed that the end result could look this good - I am really shocked by the level of skill of the plastic surgeons who have treated me, and absolutely delighted. I have always been really pleased with the original DIEP operation, but the latest bits of surgery have made such a difference to me, especially having a really realistic looking nipple.

Hey grey cat,
Sounds like I’m having pretty much same as you, with fat taken out of boob, nipple, dog ears and hip lipo, on 10 August in Birmingham, though I also need to have more of my tummy scar opened as I’ve got an adhesion on one side that pulls my tum inwards and is uncomfortable.

Would appreciate your experience of recovery time and any instructions you have had as I haven’t had any post op info.

Scone - well done- how is it going? I haven’t been in this site since it was refigured so was pleased to see your posts this morning.

I’m 8 months post mx/ DIEP, been waiting for next stage for six months though I was given the actual date at my last consultation, which I appreciated.

Best wishes to all,

nonsuch

Hi all

I had my DIEP at the end of May and have just seen the PS registrar for my first checkup since leaving hospital and he seems to think that I will be ready for nipple recon in 3 months! I think he said that they will be doing any necessary reshaping then too.

Greycat: what did you mean by dog ears? Did you mean the sticky outy bits at the end of the tummy scar?

Best wishes

Liz

Nice to read you Non Such, I’ve sent an email to you at home.
Great that you are going for your next round of surgery, onwards and upwards
Jude
xx

Hello

I had nipple recon, reduction and uplift on good side and dog ear removal all in one go about six weeks ago - just over a year after my LD flap reconstruction. I am delighted with the results of the uplift although I was very sore on that side for a few weeks after surgery. The nipple looks good but there is still a scab there which won’t drop off. It’s so frustrating! Apparently this happens sometimes but the BCN says it’s nothing to worry about. It just means I still can’t have a bath or go swimming - or book tattooing sessions.
The skin to make the new niple was taken from my breast skin but the match is remarkable.

I was going to have the fat filing procedure but have a tendency to bleed durig surgery so my surgeon decided to give that a miss. The results are still really good without it. I was two cup sizes different before my tidy up but am now a pert 36D with a nice cleavage! (not bad for 50)
I’m really pleased I went for the additionasl surgery as I feel so much more ‘normal’ now.
Lou
x

Really pleased to hear that LouB, i think I need another 2 fat transfers but then I will do the reduction/uplift and nipple recon as you have just done and will keep my fingers crossed I am as pleased as you are, it’s lovely to hear someone is so pleased with the finished product!!
Relieved to hear that it can all be done in one operation as by then I will approaching 5 or 6 operations post mx ,enough is enough or is it!!

Jude