Disclaimer: Opinions expressed here are my own and no one else's and based on my experience as a registered nurse. I have just over a complete decade of plastic surgery nursing experience. I've observed, surgically assisted with and cared for post operatively, hundreds of nipple reconstructions made by multiple different physicians.
Note: I'm not a doctor or more specifically, I'm not your doctor. I always advise to refer questions you may have, regarding your care back to your own surgeon.
🌸A lot of people ask me during a consultation if I can guide them to make a decision whether to have a surgical nipple reconstruction or remain with flat skin and just get the 3D nipple tattoo. The question is "What is right for you?" It can be confusing.
On one hand the physician practice you see may not offer this service or on the other hand, they may be pushing you to get nipple reconstruction as the "next step" of the process and you don't necessarily want another surgery but aren't sure what other options are out there.
🌸I always say that I have my own opinions on what I would personally do I ever faced with making that decision BUT, I cannot make the decision for anyone else.
I do ALWAYS answer any questions about nipple reconstruction honestly using my plastic surgery nursing experience and my experience as a professional tattooer specializing in nipple tattooing specifically.
🌸So, what is a nipple reconstruction surgery? Basically using some type of a skin flap is (elevated and folded or twisted upon itself) to fashion a protrusion on the breast mounds. Some physicians also do an areola skin graft around the nipple reconstruction. There is also a nipple "sharing" technique for unilateral reconstructions.
🌸How are they made? They are many different ways to create a surgical nipple reconstruction and it it's surgeon preference as to which technique is used. Some names you may have heard are: skate flap, C-V flap, double opposing tab method, beer can tab, bow tie flap, clover flap, twist techniques and more. All nipple reconstructions are definitely not created equal. It is very important to discuss this procedure with your surgeon and I'd highly recommend to ask to see photos of their personal work. Photos are helpful to see nipple reconstructions shown in all stages to see how the progression of healing appears on a reconstruction similar to your type. Make sure you see HEALED photos of what they look like at 6 months or longer out from surgery. They originally look quite large but many times, they flatten out eventually.
🌸PROS🌸:
🌺Appearance 🌺 It can help give an extremely natural appearance to help finish a woman's breast reconstruction, especially after combined with restorative tattooing. In a bilateral situation, the nipple reconstruction can help provide focal points the help detract from asymmetries. In a unilateral mastectomy situation this can bring a symmetrical look between the reconstructive and native breast sides, especially if her natural nipple protrudes.
🌺Pain 🌺 due to taking place after the mastectomy, pain is typically tolerated well in this area.
🌺Procedure 🌺 usually in office or out patient procedure. Can be coupled with other procedures in phase II or lll
🌺After care 🌺 not as difficult as previous bigger surgical procedures. Mostly consists of keeping area clean and applying a protective/pressure relieving dressing on top until healed.
🌸CONS🌸:
🌺Appearance 🌺
💮 They CAN flatten 💮
They can flatten as stated above, they originally look quite large in the beginning but many times, they flatten out eventually. This is frustrating for unilateral reconstruction ladies as they'd hoped for an equal nipple to be made for them.
Many things contribute to this happening:
1. Physician surgical technique
2. Was proper aftercare followed and pressure reduced from new nipple? No smoking 🚭 this can severely damage or cause tissue death to the nipple.
3. What type of breast reconstruction makes up your breast? DIEP flaps/TRAM flaps and LD flaps have more tissue beneath to recruit and fill the nipple reconstruction. Implant skin is thinner and flattens out quite often in my experience. Many physicians where I live do not offer nipple reconstruction (especially if your skin is thin) on implant based breast reconstruction and just refer them for 3D nipple tattoos for this reason.
💮They MAY NOT flatten💮
Sometimes women are told not to be afraid of the large size initially and don't worry as they'll flatten and shrink. Well, sometimes....they don't. This then requires traveling back to the days of padded bras and bandaids for some ladies.
💮 One flattened and one doesn't 💮
They do not always flatten at same rate or end up the same size. So frustrating...
💮 They're not placed in the right spot 💮
This happens a lot....it may have to do with blood supply and scar placement. However, my job (placing color around the nipple) can accentuate this asymmetry even more, once tattoo ink is in the skin. If the nipple reconstruction is flattened, I can create a 3D nipple in the proper place but, if it's really prominent and really off placed it may require surgical treatment to fix. I can usually tattoo in a way to make things as symmetrical as possible.
🌸I always say that I have my own opinions on what I would personally do I ever faced with making that decision BUT, I cannot make the decision for anyone else.
I do ALWAYS answer any questions about nipple reconstruction honestly using my plastic surgery nursing experience and my experience as a professional tattooer specializing in nipple tattooing specifically.
🌸So, what is a nipple reconstruction surgery? Basically using some type of a skin flap is (elevated and folded or twisted upon itself) to fashion a protrusion on the breast mounds. Some physicians also do an areola skin graft around the nipple reconstruction. There is also a nipple "sharing" technique for unilateral reconstructions.
🌸How are they made? They are many different ways to create a surgical nipple reconstruction and it it's surgeon preference as to which technique is used. Some names you may have heard are: skate flap, C-V flap, double opposing tab method, beer can tab, bow tie flap, clover flap, twist techniques and more. All nipple reconstructions are definitely not created equal. It is very important to discuss this procedure with your surgeon and I'd highly recommend to ask to see photos of their personal work. Photos are helpful to see nipple reconstructions shown in all stages to see how the progression of healing appears on a reconstruction similar to your type. Make sure you see HEALED photos of what they look like at 6 months or longer out from surgery. They originally look quite large but many times, they flatten out eventually.
🌸PROS🌸:
🌺Appearance 🌺 It can help give an extremely natural appearance to help finish a woman's breast reconstruction, especially after combined with restorative tattooing. In a bilateral situation, the nipple reconstruction can help provide focal points the help detract from asymmetries. In a unilateral mastectomy situation this can bring a symmetrical look between the reconstructive and native breast sides, especially if her natural nipple protrudes.
🌺Pain 🌺 due to taking place after the mastectomy, pain is typically tolerated well in this area.
🌺Procedure 🌺 usually in office or out patient procedure. Can be coupled with other procedures in phase II or lll
🌺After care 🌺 not as difficult as previous bigger surgical procedures. Mostly consists of keeping area clean and applying a protective/pressure relieving dressing on top until healed.
🌸CONS🌸:
🌺Appearance 🌺
💮 They CAN flatten 💮
They can flatten as stated above, they originally look quite large in the beginning but many times, they flatten out eventually. This is frustrating for unilateral reconstruction ladies as they'd hoped for an equal nipple to be made for them.
Many things contribute to this happening:
1. Physician surgical technique
2. Was proper aftercare followed and pressure reduced from new nipple? No smoking 🚭 this can severely damage or cause tissue death to the nipple.
3. What type of breast reconstruction makes up your breast? DIEP flaps/TRAM flaps and LD flaps have more tissue beneath to recruit and fill the nipple reconstruction. Implant skin is thinner and flattens out quite often in my experience. Many physicians where I live do not offer nipple reconstruction (especially if your skin is thin) on implant based breast reconstruction and just refer them for 3D nipple tattoos for this reason.
💮They MAY NOT flatten💮
Sometimes women are told not to be afraid of the large size initially and don't worry as they'll flatten and shrink. Well, sometimes....they don't. This then requires traveling back to the days of padded bras and bandaids for some ladies.
💮 One flattened and one doesn't 💮
They do not always flatten at same rate or end up the same size. So frustrating...
💮 They're not placed in the right spot 💮
This happens a lot....it may have to do with blood supply and scar placement. However, my job (placing color around the nipple) can accentuate this asymmetry even more, once tattoo ink is in the skin. If the nipple reconstruction is flattened, I can create a 3D nipple in the proper place but, if it's really prominent and really off placed it may require surgical treatment to fix. I can usually tattoo in a way to make things as symmetrical as possible.
💮Nipple death /necrosis 💮
This is typically a blood supply issue, either from the base of the reconstruction, pressure/folding over and kinking supply or due to smoking.
🌺Aftercare/risks 🌺
💮procedure 💮
1. It's an additional procedure that may incur an expense with co-pays and deductible costs.
2. It CAN put an additional scar on the breast, which may or may not be covered with an areola tattoo.
3. No surgery is without risk. Undergoing possible anesthesia, infection and tissue death/loss are a few of them.
4. Radiation causes additional risks. Many times surgical nipple reconstruction is not an option in a radiated skin field.
5. The protrusions and surrounding skin in the areola field are not colored adequately for a completed appearance. Areola restorative tattooing to usually desired for the "grand finale or finishing touch".
💮aftercare💮
Even though it's relatively easy, there's still aftercare required and avoidance of water activities until healed.
🌸Your physician will determine if you are a candidate for this procedure. If you've had radiation or have thin skin, you may not be eligible.
🌸 In conclusion, your finishing touch can be a 3D Nipple Tattoo on completely flat skin or over a surgically created nipple reconstruction. The beauty is, you can CHOOSE! Either way, you can achieve a finished appearance to your breast reconstruction. I love your participation in placement, color selection and details you choose to have added. There is a very tolerable recovery for the tattoo sessions which usually requires keeping the area clean, moisturized and protected. I tattoo in 2 visits done about 10 weeks apart.
🌺Aftercare/risks 🌺
💮procedure 💮
1. It's an additional procedure that may incur an expense with co-pays and deductible costs.
2. It CAN put an additional scar on the breast, which may or may not be covered with an areola tattoo.
3. No surgery is without risk. Undergoing possible anesthesia, infection and tissue death/loss are a few of them.
4. Radiation causes additional risks. Many times surgical nipple reconstruction is not an option in a radiated skin field.
5. The protrusions and surrounding skin in the areola field are not colored adequately for a completed appearance. Areola restorative tattooing to usually desired for the "grand finale or finishing touch".
💮aftercare💮
Even though it's relatively easy, there's still aftercare required and avoidance of water activities until healed.
🌸Your physician will determine if you are a candidate for this procedure. If you've had radiation or have thin skin, you may not be eligible.
🌸 In conclusion, your finishing touch can be a 3D Nipple Tattoo on completely flat skin or over a surgically created nipple reconstruction. The beauty is, you can CHOOSE! Either way, you can achieve a finished appearance to your breast reconstruction. I love your participation in placement, color selection and details you choose to have added. There is a very tolerable recovery for the tattoo sessions which usually requires keeping the area clean, moisturized and protected. I tattoo in 2 visits done about 10 weeks apart.
If you're undecided, I suggest looking at physician photos, talking with those who had nipple reconstruction or the 3D tattoo regarding their experiences, and also trying NIPPLEBACKS. They're temporary nipple tattoos that can really help you decide what's right for you!
https://www.nipplebacks.com/shop-1
XOXO,
The Nipple Fairy 🧚♀️
https://www.nipplebacks.com/shop-1
XOXO,
The Nipple Fairy 🧚♀️
