Nipple and Areola Reconstruction in Cyprus

Nipple surgery reduces the size of the nipple, corrects nipples that are invaginated into the areola, or reshapes the nipple-areola complex to make it more proportionate.

It can be done on its own or combined with another operation — breast lift, augmentation or reduction. For patients who have had a mastectomy, nipple reconstruction means creating a new nipple and areola as part of the breast reconstruction, and is an important final step in that process.

Inverted nipples

One of the most common reasons for nipple surgery is inversion or retraction. Nipple inversion is a common abnormality in which the nipple points inwards rather than outwards and lies flat except when stimulated.

Beyond the appearance, inversion can cause difficulty with breastfeeding and further problems with age. It does not usually cause discomfort.

What the operation involves

Anaesthesia Local anaesthesia, administered by a consultant anaesthetist, unless the procedure is combined with another breast operation.

Incisions Placed at the junction of the areola with the breast skin, where they are not visible once healed.

Closure The incisions are closed in layers to minimise scarring.

Techniques

There are several ways to reconstruct a nipple. Which is appropriate depends on the condition of the breast, medical history and what the patient wants, and is discussed at the first consultation.

Skin flap reconstruction Small skin flaps from the reconstructed breast are folded and stitched together to create a mound that forms the new nipple. Additional skin, fat or synthetic filler can be used to give more projection. The areola is created afterwards by tattooing, or with skin taken from elsewhere — for example loose skin from the lower abdomen.

Nipple and areola reconstruction (the Hammond flap) Larger skin flaps from the breast are used to recreate both the projection of the nipple and the areola.

Autologous graft, or nipple sharing Where only one breast was removed, part of the nipple of the unaffected breast can be grafted onto the reconstructed breast to form a new nipple. The unaffected nipple has to be large enough.

Medical tattooing Tattooing is used to produce a natural-looking nipple and areola on a reconstructed breast.

Nipple reduction The projection of the nipple and the size of the areola are reduced for patients who are uncomfortable with a long nipple or large areola. The top of the nipple is removed and small incisions are used to excise excess tissue.

Recovery

Recovery depends on the extent of the procedure. Most patients return to normal activity within one to two days.

Nipple reconstruction is a day case — there is no overnight stay unless it is combined with another breast operation.

An antibacterial nipple shield or another protective dressing is taped over the new nipple as part of the post-operative plan. Avoid soaps with harsh chemicals, which irritate the area.

Immediately after surgery and for the first days the nipples may look larger, red, swollen or more pointed than expected. This settles as healing progresses.

Results are long-term, though changes in body weight, pregnancy and ageing may alter the appearance of the nipple.

Where the surgery takes place

Dr. Stavrou performs nipple reconstruction in accredited medical centres in Cyprus (Nicosia and Limassol), Greece (Athens) and Malta (Sliema). After the procedure the patient is transferred to the recovery suite and monitored by the clinical team.