The final stage of the breast reconstruction is the reconstruction of the nipple-areolar complex (NAC). Usually, this is performed after the nipple reconstruction, however, it may be done without it as well. While some women opt not to have anything further done after the breast reconstruction, as discussed in the last post, these relatively benign procedures are simple and easy to perform, and “complete” the breast reconstruction.
I usually perform a nipple reconstruction first if one decides to proceed with the NAC. If one foregoes the actual nipple reconstruction and only have a NAC recreated, options for such are skin grafts and tattoos. The same techniques are used if a nipple reconstruction is performed as well.
Skin grafts are usually taken from the medial thigh or groin area as the skin is typically darker in color and the donor site is hidden. The skin graft recreates a great appearance to the areola. This procedure is tolerated very well and may be done via local anesthesia or general/sedation. Little recuperation time is required afterwards.
The other popular technique is areolar repigmentation. This is done via tattoo under no or local anesthesia. Often times the NAC area is still insensate from the previous surgery, and the tattoo needle is tolerated very well. As with a tattoo, pigmentation (instead of ink), is injected into the superficial dermis to repigment the area. This, as well, gives a great appearance to the areola. This is my preferred method. I perform this with only topical anesthetic in the office as a short procedure. It also avoids another “surgical procedure”.
Both techniques are very simple to perform, benign procedures with little down-time and few complications, and give excellent appearance to a reconstructed NAC.
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