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