You can decide if you want to have your nipple and areola (the dark area around the nipple) reconstructed. They are optional and usually the final phase of breast reconstruction. This is separate surgery that is done to make the reconstructed breast look more like the remaining one. It can be done as an outpatient under local anaesthetic. It is normally done after the new breast has had time to heal – usually about 3-4 months later.
The ideal nipple and areola reconstruction requires that the position, size, shape, texture, colour and projection of the new nipple match the natural one. Tissue used to rebuild the nipple and areola also can be taken from other parts of your body, e.g. the newly created breast itself, opposite nipple, ear, eyelid, groin, upper inner thigh or buttocks.
Once the new nipple has been created it, and the areola, can be tattooed. It is usually done under local anaesthetic either using a cream or an injection. The procedure usually takes 30/40 minutes. A semi-permanent pigment is injected under sterile conditions to prevent infection, the aim being to match the colour of the nipple and areola of your natural breast. The amount injected will vary slightly from person to person to give the best appearance. Sometimes the procedure needs to be repeated. Two coatings usually lasts approximately 18 months to 2 years. The tattooing itself is not painful, but the area may feel sore for a few days and you may be advised to wear a dressing over the area for about a week, which may need to be changed in case the dye leaks through.
If you do not want to go through another operation to make a nipple, you can ask to have a silicone stick-on nipple which can be attached to the reconstructed breast. Nipple prostheses are normally made in the moulding room at the hospital.