Breast refinement is surgery to improve the look of reconstructed breast(s).
Nipple and areola reconstruction
If the nipple and areola are removed during mastectomy, they can be recreated. For some women this is important and completes the look of their reconstructed breast(s). Other women decide that it is not necessary.
Nipple and areola reconstruction is usually done at least 3 months after breast reconstruction surgery. This gives time for the reconstructed breast(s) to ‘settle’ (they may fall slightly over time). Often the nipple is reconstructed first, followed by the areola a couple of months later.
Options for reconstructing nipples include:
- medical tattooing to create a flat circle on the skin that is the colour of a nipple
- using skin and tissue from the tissue of the reconstructed breast(s) to create a raised nipple
- taking a small skin graft from the end of a reconstruction scar (usually from the abdomen or back) to create a raised nipple.
Reconstructed nipples will not feel and behave as they did before mastectomy. Nipple sensation will not be the same and there may not be any feeling in the nipple at all. Reconstructed nipples will not change size with changes in temperature.
An alternative option is to use stick-on nipples that stay in place for several days at a time.
Options for reconstructing areolas include:
- medical tattooing: this is usually done a couple of months after the reconstructed nipple(s) have had time to heal and is usually done in an outpatient setting
- transferring skin from the groin area, where the skin colour is similar to that of an areola.
"When I was first going to have the reconstruction... I didn't think I'd bother with that nipple reconstruction... But when I saw what a great job he (breast reconstruction surgeon) did (with the breast reconstruction), I thought 'Well, I'd just finish it off'.... And that was really good because even though the whole reconstruction was good, just seeing that patch of colour again just sort of brings it that much closer to being normal."
Breast refinement surgery
Some women choose to refine their reconstructed breast(s) to create a more natural or pleasing appearance. They are also called equalisation surgeries.
Options include:
- lifting of both breasts (mastopexy)
- contouring (usually involving liposuction) of the reconstructed breast(s) to provide an improved breast shape.
Additional options for women who have only one breast removed include:
- breast reduction (reduction mammoplasty) of the non-reconstructed breast
- breast enlargement (breast augmentation) of the non-reconstructed breast
- lifting of the non-reconstructed breast to match the reconstructed breast
Breast refinement procedures may be undertaken at the time of breast reconstruction or at a later time. Your breast reconstruction surgeon will be able to discuss breast refinement surgery options with you.