During a risk-reducing mastectomy the whole breast is removed, usually including the nipple. It may sometimes be possible to keep your nipples if you are having immediate reconstruction.
There are two options for keeping your own nipples:
The nipples can be left attached to the skin of the breasts and only the tissues under the skin are removed.
The nipples with or without their surrounding skin may be removed with the rest of the breast tissue and then attached (grafted) on to the reconstructed breasts.
Occasionally nipple reconstruction is done at the same time as breast reconstruction, but it’s usually done some time afterwards. This lets the breasts settle into their final shape so the surgeon can position the nipples accurately.
The time between operations for breast and nipple reconstruction may vary, but it’s usually about 4–6 months.
Your nipple shape may be reconstructed using a skin flap, where the surgeon folds skin on your new breasts into a nipple shape. This procedure can be done under a local or a general anaesthetic.
It’s usually possible to go home on the same day. When you go home you will have a dressing over the nipple areas, which is usually left in place and removed when you attend an outpatient appointment. Your nursing team will advise you about this.
A reconstructed nipple doesn’t react to temperature changes or touch – or have the same sensation as a natural nipple.
Nipple/areola tattooing (micro-pigmentation)
Back to top
Once you have new nipple shapes, you can have the new nipples and areas around them tattooed. This gives the nipples and areola a more natural colour.
Nipple tattooing is done in the hospital and usually takes about 30–40 minutes. You’ll be given a local anaesthetic cream or injection to numb the nipple and surrounding skin. The procedure may need to be done more than once to give the best result.
Tattooing isn’t usually painful but the area may feel tender (like a graze) for a few days afterwards. Tattoos usually last about 18 months to two years.
If you decide you don’t want to have another operation to make nipples, you may prefer to have silicone nipples (see below), which you can attach to your reconstructed breasts.
Once the nipple is fixed to the breasts with a special adhesive, it can stay in place for up to three months.
Ready-made nipple prostheses come in various shades and sizes. It may be possible to mould these from the existing nipples before surgery.
A selection of nipple prostheses