Nipple Tattoos, Prosthetic Nipples or Nipple Reconstruction?
Undergoing a mastectomy is a dramatic step in our breast cancer journey, and it is always laden with many emotional questions and physical challenges. One major decision for patients of both unilateral and bilateral mastectomies is whether to reconstruct the breast, with many new options in cosmetic techniques available. Another crucial aspect to consider is nipple reconstruction or restoration.
For many of us, the nipple is not just a physical feature – it holds symbolic meaning and connection to our pre-cancer selves as women and (current or future) mothers. Fortunately, there are innovative approaches available today that offer artistic ways to recreate or save this anatomical element, including nipple prosthetics, surgical reconstruction and preservation, and tattooing. To learn more about various nipple options following mastectomy, read on.
A Personal Choice
The decision to pursue nipple restoration is deeply personal and entirely ours to make. Some women feel as though it’s an essential phase of surgery, to help restore a sense of body familiarity and emotional completeness. Others prefer to avoid yet another procedure following mastectomy, opting for round, smooth breast mounds instead. Plastic surgeons typically recommend waiting at least four months after breast reconstruction surgery before electing nipple reconstruction or tattooing. This waiting period allows the tissue to heal and for implants to settle into their final position. It's important to be satisfied with the overall reconstruction before moving forward with nipple restoration.
Nipple-Sparing Mastectomy
A variation of skin-sparing mastectomy, nipple-sparing mastectomies involve the removal of breast tissue through a small incision, thereby preserving the outer skin and nipple. While these procedures provide good cosmetic outcomes, they are mostly performed for prophylactic procedures to prevent breast cancer. According to Elisa Port MD, Chief of Breast Surgery and Mount Sinai Hospital in New York, women who have tumors close to the nipple or extensive cancer in the milk ducts might be at higher risk for recurrence if the nipple is spared. In this way, nipple sparing mastectomies are not considered a standard breast cancer treatment.
Nipple Reconstruction: Art & Science in Harmony
Nipple reconstruction surgery is a well-established outpatient procedure that offers a tangible projection from the breast, designed to resemble a nipple. This approach involves using skin from the nearby breast area to create a new form. The surgeon makes precise incisions, molds the tissue into a nipple shape and secures it with stitches. In some cases, a skin graft may be used to create the areola. Color and shading can then be added through tattooing, enhancing the natural appearance further.
While nipple reconstruction surgery delivers a good cosmetic outcome, it's important to recognize that a reconstructed nipple won’t fully replicate the look and feel of the original nipple. Additionally, most women experience a loss of sensation in the breast area after mastectomy, which extends to the nipple area. Despite these limitations, nipple reconstruction can provide a powerful psychological boost and encourage sentiments of physical restoration.
Nipple Prosthetics: Bridging Restoration Realms
Another avenue that is gaining traction is the use of nipple prosthetics. These remarkable creations provide an option that bridges the gap between surgical restoration and tattooing. Nipple prosthetics, often crafted from silicone, are adhered to the breast mound with a non-toxic adhesive or a magnetic connection. While separate from the body, they seamlessly blend in with the breast, providing a tactile projection that mirrors the appearance of a natural nipple. With an array of sizes, shapes and colors available, nipple prosthetics offer a non-invasive, inexpensive option and can be particularly appealing for those who have other medical needs or who want a more immediate and reversible option.
3D Nipple Tattoos: Elevating Realism
In recent years, a growing number of individuals have been opting for 3D nipple tattoos. These tattoos, applied by skilled artists using needles to insert pigment into the skin, create a life-like image of a nipple with a three-dimensional appearance. This technique offers fine detail, shading and coloring that may surpass what traditional surgery can achieve. Tattoos are also significantly less invasive than nipple reconstruction surgery.
Tattooing is performed after the breasts have healed from reconstruction surgery, typically four to six months post-procedure. The process itself usually takes about half an hour per nipple. While some discomfort may be experienced, it's generally less painful than other tattooing processes due to the diminished sensation in the reconstructed breast area.
Choosing What's Right
The decision between nipple prosthetics, surgical reconstruction or 3D nipple tattoos is deeply personal, and taking the time to feel what’s right for our body and lifestyle is essential. Consulting one’s plastic surgeon is also a key part of the process, to better understand our unique needs and physical options.
It's important to note that not everyone is a candidate for nipple restoration. Factors such as radiation treatment effects, thinning of breast skin, chest lymphedema and a history of infections can impact eligibility.
Regardless of which choice we make, feeling a sense of autonomy and control following mastectomy can be a valuable aspect of our healing journey. Each body is unique, but hopefully, the decisions we make help us navigate our recovery, empower us as women and enable us to reclaim a sense of self and femininity following change.
“So many women who I’ve tattooed say: ‘I want a sense of normalcy when I come out of the shower and look in the mirror or change clothes at the gym. I don’t want to be self-conscious.’” – Eden Davis, a physician assistant at Memorial Sloan Kettering Cancer Center and one of the specialists who tattoo realistic-looking nipples and areolas on people who have them removed during surgery.
