My partner (Liz) has to have a bilateral mastectomy because of DCIS. Luckily, the plastic surgeon is happy to reconstruct using “inflatable” implants. We are happy with this because our research says that it is likely to get the best results for her circumstances. BUT, Liz wants nipples reconstructed, too. Her surgeon says he will do this using the “flap” technique, but this is likely to flatten out over time. My question is…Is there such a thing as a small “silicone or plastic implant” that could be inserted just under the skin where the nipple would be, so that there would be a small mound that would be a more natural shape, and less likely to flatten over time??? If a small implant could be placed under the skin, the normal tattooing process could provide the correct colour and tones (as is used at the moment). If there is no such “implant” why not?? Is there a medical reason, or is it more likely a corporate “profitable” reason. Or has it simply never been thought of before?? We know that sometimes a small piece of the patients cartlidge can be used as an “implant” but we are also aware that this can be “re-absorbed” and also flatten out over time. I have researched as much as possible about this, but can’t find anything at all. I would like to help my partner as much as possible to get through this, so any information anyone may have would be appreciated. Thanks.
Hi Shaunlev,
end 2005 I had a bilat mast for DCIS like Liz, and chose immediate recon with implants (the final size, not the inflatable ones). I also lost my nipples. They were reconstructed nine months later - the surgeon would not do it less than 6 mths after the mast as she said the implants need that much time to settle so you can choose the right site for the new nipples. The skin at the site was cut in a kind of cloverleaf and then pulled up into nipple shape, and around that was grafted skin for the aureole. This skin came from very high up on the inside of my thighs, where the skin is naturally a bit darker. I could have had tattooing but didn’t bother as my skin is naturally quite pale and the contrast looked realistic enough. The shape of the nipples is very natural and - 18 mths on - they have not flattened. I had been worried before as a friend who had the same op (a different surgeon!) had nipples which were very prominent but mine are good. My surgeon did say in some cases the nipples flatten over time, but certainly mine have not. I hope this helps - if you have any further questions I’ll be happy to reply if I can. Lucky Liz to have such a caring and considerate partner!
petitepart
Hi Petitepart,
Thank you for the information and assurances. We went to see Liz’s plastic surgeon again today, and we told him about some of the postings from the ladies on this forum where they have been very happy with their nipple reconstruction. We are aware that it needs around 6 - 9 months for things to settle down before any reconstruction should be attempted. But, he is quite assertive that the reconstruction you describe would not be a permanent solution (maybe he’s not so confident in his own work, which is worrying). Obviously Liz is quite upset about this (she wants the aesthetic results to be the best that’s possible, and to Liz, this is as important as removing the offending disease). I did manage to do some more research today, and finally found someone that says they can mould the correct shape into “carve-able surgical silicone”, and then insert these under the skin to give the correct 3D shape. I will be investigating this more, as well as trying to get a consultation with another plastic surgeon regarding the “clover-leaf” procedure.
At the moment I am learning as much as possible about BC (especially DCIS) so that I can discuss things in greater detail with Liz and her surgeons. This site is fantastic as a source of information, and there are so many brave Ladies willing to share their experiences and information. Thank you all. It does help us “other-halves” to understand more, as well as the patient.
Shaun.