Are There Nipple Implants for Breast Reconstruction?

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.

Doctor Answers 23

Your own tissue best for nipple reconstruction

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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

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Nipple reconstruction is performed on the breast mound with local flaps after the implant or autologous tissue reconstruction has healed.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Nipple reconstruction techniques

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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.

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

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Nipple reconstruction

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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.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Improve Implant Shape for Nipple in Breast Reconstruction

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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. 

Nipple reconstruction

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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.

Elizabeth Kim, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 29 reviews

Nipple reconstruction

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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..

Nipple reconstruction

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Nipple reconstruction is often done with using local skin and subcutaneous fat to create the nipple projection. The areola will be tattoo in later to recreate the whole complex. Plastic surgeons have use cartilage, alloderm and other materials to maintain the nipple projection. However, none have maintained prolong result. Recently, there is 3-D nipple tattoo technique that create a realistic nipple-areola complex without surgery.
Overall, a nipple-areola reconstruction is an important component of breast reconstruction.

Mytien Goldberg, MD, FACS
Los Angeles Plastic Surgeon

Nipple implants

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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 Shortt
Oakville Plastic Surgeon

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 85 reviews

How to make nipple reconstruction look more real.

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That is an interesting question.  More and more my patients are opting for 3D nipple tattooing!  This newer technique has excellent results.  There is also the ability to use fillers and grafts to help augment the nipple reconstruction.

Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.