Are there nipple implants or cohesive gel implants (formed) that are made with a shape that could create a more normal looking breast/nipple? It would seem better to have a whole breast shape with a protruded areola and nipple bump for people who are undergoing total breast reconstruction.
Are There Nipple Implants for Breast Reconstruction?
Doctor Answers 23
Your own tissue best for nipple reconstruction
The best way to reconstruct a nipple is to use your own tissue to create the projection. This will give the most natural look. Some patients can supplement this with restylane to give more projection if some is lost. I usually will add a skin graft ato create the areola and tattoo it for color match to the other side.
As far as shaped implants, they are not available in the USA for routine use at this time.
Nipple reconstruction is performed on the breast mound with local flaps after the implant or autologous tissue reconstruction has healed.
Nipple reconstruction techniques
There are various techniques and options for nipple reconstruction - decision on which is surgeon dependent. To answer your question, there are companies that create "structures" for nipples, which are meant to be placed beneath the reconstructed nipple flaps created with your skin. I typically create the nipple using your own skin flaps at the anatomically-appropriate position. Depending on the quality of your skin there will depend on if I use a nipple graft or not. Often times when a flap is used for the breast reconstruction, the tissue is much thicker, and thus, grafts are not typically needed. If a graft is required to add additional durability and projection, I personally do not use foreign substances. I prefer to use your own dermis, which I harvest from one of your previous scars. Finally, I like to tattoo the nipple-areolar complex rather than placing skin grafts as I find it more aesthetically-pleasing.
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There are numerous ways to create a new nipple. Usually a local flap is used to create the nipple projection, often after the skin to be used and the new areola is tattooed for color as it is easier to tattoo the skin flat than when standing as the new nipple. The problem is maintaining the nipple project as it tends to shrink and flatten over time. Various materials can and have been used to augment or maintain this projection from fat grafts, dermal graft, alloderm, cartilage and even small implants. You can even do nipple-sharing by taking half of the good nipple if it is large, and using it as a graft.
Improve Implant Shape for Nipple in Breast Reconstruction
You ask an excellent question. Unfortunately we are limited in the projection and shape of implants. We frequently wish we had a choice of implants with more projection to achieve a more conical look as the foundation for nipple reconstruction. Implants were initially designed for breast augmentation, hence they lack that tip projection that would improve the shape after reconstruction. Even the newer shaped implants do not fully match the projection of a natural breast in many cases. As far as the nipple reconstruction itself, this is best performed with the patient's own tissue.
Implants with built in nipple are not available in the US. Nipple reconstruction is performed by using your own skin where a nipple should be. The skin is wrapped upon itself and sutured together so it sticks out like a nipple. Tattoo of the areola is then performed. Results can be excellent. Ask your plastic surgeon to see photos.
Technologies hav had some patients fortunate enough to undergo 3-D nipple tattooing This gives the appearance of a three-dimensional tattoo without having any surgical incisions. However not all plastic surgery practices offer this..
Overall, a nipple-areola reconstruction is an important component of breast reconstruction.
I think your question is great. As best I know there is no nipple projections on breast implants. It would be hard to get enough projection through the skin. If it poked up too much it would likely erode the skin.
Typically nipple reconstruction is done with your own skin. Flaps of skin are elevated and turned on themselves. In order to create lasting elevations I usually sit this on a platform of deepithelialized skin. There are other tricks we use to help things look natural and maintain their projections.
Dr Rodger Shortt
Oakville Plastic Surgeon
How to make nipple reconstruction look more real.
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