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Loss of projection after nipple reconstruction is common. Nipple reconstruction surgery can be repeated to improve projection.
Thank you for your question. I would need to examine you in-person to better answer your question. Flattening of the nipple after reconstruction is not uncommon, but it is possible to revise a nipple reconstruction. There are several different techniques that can be used, including adding filler or your own fat to increase the projection of the nipple and/or repeating the nipple reconstruction. I perform nipple reconstruction in our fully-accredited operating room under local anesthesia or IV sedation as an outpatient procedure. I recommend you speak with a fully-trained plastic surgeon to discuss your options.
There are many ways to reconstruct a nipple and some flatten out more easily than others. You may benefit from a surgical revision. There is also an option to add some filler, or volume to the nipple to make it protrude again. This can be done with many of the hyaluronic acid fillers on the market, or with Radiesse. Radiesse contains calcium so it may show up on a mammogram, but tends to hold its shape for a long time. Fat is also an option, but requires surgery. Good luck to you.
Thank you for you question. Unfortunately, reconstructed nipples do flatten out over time. You do have options to regain some projection in the nipples. It is possible to place injectable HA Filler such as Juvederm or Voluma to regain the projection. This can be done in the office. The disadvantage of this is that insurance does not cover this and it is temporary. Another thing that can be done is that you can have fat grafting or placement of alloderm or a dermal graft to increase projection. Please consult with a plastic surgeon board certified by the American Board of Plastic Surgery to learn about all of your options for revision nipple reconstruction. Best wishes! Rahul Vemula, MD Double Board Certified Plastic and Reconstructive Surgeon
YES! It is not uncommon for reconstructed nipples to flatten over time. There are different flap techniques to create projecting nipples, and in most cases, secondary or revision nipple reconstruction can be performed to add projection to a flattened nipple. Occasionally, fat grafting or the use of acellular dermal matrix are used to add support to the flap reconstruction.Good luck!Stephen Harris, MD
The Ryan Flap is an excellent procedure to re-define the Inframmary fold. The inframmary fold can be disrupted after procedures such as implant reconstruction as well as TRAM Flap. Without examining you and looking at pictures to see exactly what si going on, it is hard to render an opinion...
Thank you for your question and for sharing your photos. It is difficult to give you an exact answer without examining you and understanding your reconstructive goals. As you said, there will always be some asymmetry and this is normal, however, it should be possible to improve your asymmetry...
I agree with the opinion you obtained. You should have a pocket exchange and place the implant above the muscle. With regard to rippling, autologous fat grafting would be able to mitigate this to improve the result.
