Newly reconstructed breasts are called "breast mounds" and don’t come with nipples and areolas. With a nipple reconstruction and tattooing, the reconstruction is considered complete. Nipple and areola reconstruction are separate procedures, which are done three or four months after the reconstruction.
A completely reconstructed breast should look like the original breast, restoring symmetry. The patient should be able to wear the usual bras, blouses and even swimsuits. In the nude, it will be less obvious that it is a "new" breast if the reconstruction is complete, but scars will still remain. Self-adhesive nipples are also available, to use during healing, or as a long-term option.
Occasionally nipple reconstruction is done at the same time as breast reconstruction, but it is usually done some time afterwards. This lets the breast settle into its final shape so that the surgeon can position the nipple accurately, in line with your other nipple. The time between operations for breast and nipple reconstruction may vary, but it’s usually about 4-6 months.Nipple shape may be reconstructed using a:
These procedures can be done under a local or a general anaesthetic. It’s usually possible to go home on the same day. A reconstructed nipple doesn’t react to temperature changes or touch - or have the same sensation as a natural nipple.
Once there is a new nipple shape, then the new nipple and area around it tattooed to match the colour of the nipple and areola (darker area around the nipple) of the natural breast. This is done in the hospital. A local anaesthetic cream or injection is given to numb the nipple and surrounding skin. A tattooing session usually takes 30-40 minutes. The procedure may need to be done more than once to give the best result. The tattoo usually lasts approximately 18 months to two years. Sometimes the opposite nipple is also tattooed to ensure a good match. Tattooing isn’t usually painful but the area may feel tender (like a graze) for a few days afterwards.
Fat is extracted from other parts of the body using liposuction and then injected to fill out any contours or dips in the reconstructed breast. With Liposuction fat is broken up using a hollow tube called a canula and the fat suctioned out, reducing contour excesses. Usually 50% of the fat will be naturally absorbed by the body and the procedure may need to be repeated.
A reconstructed breast will not precisely match your natural breast. If you have large breasts, you may need a reduction of your opposite breast in order to match the reconstructed breast. If you have smaller breasts that sag, you may need a lift of the natural breast or augmentation with an implant to improve the shape and facilitate symmetry. Both reductions and lifts leave permanent scars on your breasts. The precise location of the scars and technique used to balance the breasts will be explained in great detail by Dr. Venkat Ramakrishnan, when planning for this procedure.