Filler for failed nipple reconstruction?

Question

Thank you for opportunity to post a question. I'm 3 years out from prophylactic skin sparing bilateral mastectomy with nipple reconstruction utilizing the nipple reconstruction cylinder. Although the cylinder technology seemed promising unfortunately, they haven't maintained projection.I'm wondering if products such as Radiesse, and others may be an option to gain projection. Are these products approved for this type of use and what are the potential risks? Thank you!

Lewis Albert Andres, MD · Answer

Hello!  Thank you for the question!  Flattening of the nipple following nipple-sparing mastectomy or nipple reconstruction is expected and not uncommon. If you desire additional projection, there are some things that may be done to ameliorate this. Surgical procedures such as placement of a graft can be done. Either your own dermis, fat, cartilage, or a biologic graft can be placed beneath the nipple to add projection.  Fillers are only temporary. I typically utilize your own tissue to perform this, as it is less reactive with the least complications, in my hands. Hope that this helps!  Best wishes!

Allen Gabriel, MD, FACS · Answer

Thanks for your question.Unfortunately some of the reconstructed nipples over time can lose
projection and volume.Fillers are a
quick and easy solution for this and they can be used.I have used both Radiesse and Juvederm for
this and has worked out great since you see an instantaneous projection.You can assess how much you would like to
have injected as your plastic surgeon is injecting.This is temporary and depending on how long
the filler lasts, you will need to have it re-injected.Best of Luck.

Jacqueline Anne Luong, MD · Answer

Nipple flattening is not uncommon.  Fillers do not tend to work as it is difficult to add filler due to the amount of scarring present.  And they are only temporary.  Repeating the nipple reconstruction usually has good results but sometimes the desire projection can not be achieve.

Jon E. Rast, MD · Answer

It is not uncommon to have flattening of the nipple after reconstruction. In my experience the cylinders don't work.  It might be possible to revise the nipple reconstruction. Fillers such as Radiesse would be a temporary fix and considered off label use. I would discuss your concerns with your surgeon.

Timothy Connall, MD, FACS · Answer

Please discuss your concerns with your plastic surgeon.  The use of Radiesse for nipple reconstruction would be "off-label" and not an FDA approved use.Best wishes.

Robert Whitfield, MD · Answer

Yes I have seen RADIESSE used for this purpose. Cartilage grafts can also be used but requires a surgical procedure.

Filler for failed nipple reconstruction?

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