Are There Nipple Implants for Breast Reconstruction?

Nipple Reconstruction is something that can be performed as a short, in-office procedure. It takes about 30 minutes (per side). This is done by making small incisions in the skin and folding the skin to create the projection. About 6-8 weeks after nipple reconstruction has been performed, patients are able to have aerola tattoos. 

Nipple areolar complex reconstruction is the final crucial step in breast reconstruction. Typically, the nipple reconstruction is performed using the patient's own tissue via local flap. This is followed by tattoo approximately 6 weeks later. Fat, fillers, dermal grafts can often be used to improve nipple projection over time (they will often settle). As always, consult with your board certified plastic surgeon before making any decision.

Hi there,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 ShorttOakville Plastic Surgeon

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.

Nipple Reconstruction is an art and is typically performed after breast reconstruction. There are a myriad of techniques to reconstruct the nipple, including local flaps and subcutaneous cartilage placement.
These techniques are surgeon dependent. In general, the nipple resumes a normal shape and size but lacks the sensation of a normal nipple.

The plan for the nipple and areola (pigmented skin around the nipple) depends on both oncologic needs (treating the cancer), and cosmetic issues. Your breast surgeons may need to remove the nipple and areola if your cancer is close to or could be close to the undersurface of these structures. It is not a good idea to leave cancer in the breast just to save the native nipple or areola. Typically Dr. Albright will discuss the cancer issues with your breast surgeons but will always defer to your breast surgeons when it comes to treating your cancer.
There are also cosmetic considerations when trying to keep the nipples. If the breasts are very large, there may be too much skin of the breast to be able to adequately fill with an implant. Additionally, as the nipple will be the furthest skin from intact blood vessels (all the vessels that were traveling through the breast tissue itself are now gone), there can be issues with wound healing at the nipple. Occasionally, the blood supply to the nipple is not adequate even if the patient was an ideal nipple-sparing mastectomy patient, and, unfortunately, this will only be apparent during the surgery (when you are asleep on the table). Therefore, Dr. Albright always discusses the possibility of losing a nipple during the procedure even if the plan is to save the nipple. There are very good tattoo nipple reconstruction options if that is the case.

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.

As has been discussed below, nipple areolar reconstruction can be performed a number of ways: local flaps, skin grafts, cartilage grafts, nipple sharing grafts, tattooing, and even as simple as the application of stick on silicone.Regarding your specific question, no breast implant is available with a nipple in the US. However, there is at least one commercially available nipple reconstruction cylinder made of a biologic material that can be wrapped in local flap tissue to achieve a projecting nipple. (Cook Biodesign Nipple Cylinder).  I do not personally have experience with this nipple cylinder, but I wanted to provide this information for completeness sake.

Nipple reconstruction is typically performed at the end of a reconstructive surgery.  This places the nipple on the position centered on the implant.  This is usually done with reconstructive flaps from the localized tissue followed by a areolar tattooing.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..