Areola and nipple reconstruction

The nipple is made up of milk ducts and glandular cells, making it an essential part of the breast, particularly for milk production. During mastectomy for breast cancer treatment, it is often necessary to remove the nipple, as it may be affected by the disease or treatments, especially in cases of involved margins. Once the mastectomy is completed, areola and nipple reconstruction usually occurs at the end of the process, after full healing and any additional treatments such as radiotherapy.

Nipple and areola reconstruction is often part of a broader breast reconstruction plan, which may include procedures such as implant-based reconstruction or autologous fat grafting. These techniques aim to restore breast volume and shape with a natural appearance, while areola and nipple reconstruction refines the result by providing full symmetry and an optimal aesthetic outcome. The success of this procedure depends on several factors, including the quality of the available skin for grafting and the chosen technique. Thanks to increasingly refined methods, it is now possible to obtain a stable and natural result that lasts for many years.

Nipple and areola reconstruction can be performed using several techniques adapted to each patient. It is usually done through skin grafting. The goal is to recreate an appearance that is as natural and harmonious as possible. Grafting techniques vary depending on the patient’s skin characteristics, such as colour and texture, to ensure that the reconstructed areola blends seamlessly with the breast.

For the nipple

Several options exist for nipple reconstruction, depending on each patient’s preferences and situation. Harvesting half of the contralateral nipple is a common method, but a local flap or a skin graft taken from the earlobe may also be considered. Each method aims to achieve a natural-looking result with a texture and shape close to the original nipple.

For the areola

Areola reconstruction is performed using a skin graft taken from specific areas such as the groin fold or the outer border of the labia majora, where the skin is naturally pigmented. This allows the recreated areola to match the colour and texture characteristic of natural areolar tissue.

The procedure is performed under conscious sedation or light general anaesthesia, depending on the patient’s preferences and needs. The goal is to minimise discomfort while ensuring a successful surgical outcome. It lasts less than one hour. Returning home is usually possible the following morning.

Postoperative recovery is usually straightforward. Care focuses mainly on maintaining the graft and managing the incisions. Local care to the breast and donor site is required for about 15 days. There is generally no significant pain. Postoperative follow-up is scheduled to ensure proper healing of the nipple and areola.

The result becomes visible after one week, when the breast dressing is removed and the graft has taken. About one month is needed for full consolidation. A one-week work leave may be recommended, although 2 days are often sufficient for sedentary jobs.