Nipple reconstruction
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I did the origami style nip recon. Took about 40 min under local and was definitely a piece of cake. My PS and I chatted the whole time. He told me to protect them for about 6 weeks but I did it for 3 months just to be sure. It has shrunk some but not totally and looks very normal even when looking down. I couldn't shower for about 5 days. No down time. I went to Target and bought a tube of those makeup pads. I would cut a hole out of one and put it over the nipple. Then I put a whole one on top of that and tape it on. Then wore a bra over that. About 6 months after that, I got a Vinny tattoo and it now looks amazing!
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Robinblessed, I'll be anxious to here how you recon goes. I get mine done Sept. 30. It's been two years since my DIEP recon, can't wait to be done.
My first PS was going to do the origami style. He moved and I had to use someone else for this time. He is doing skin grafts from my side book area along the mx scars. Is this the same as a skate flap?
I will happily be sound asleep for the procedure.
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Does anyone know how long after origami style nipple reconstruction one must wait before getting areola tatoos?
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My PS said 3 months. I waited 6 but that was how long out I had to wait to get to Vinnie.
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bikefam, I also had my fold repaired and that required significant restrictions on arm movement. I think if I had only had nipple repair done I just wouldn't have been able to wear sports bras (due to the compression on the nipple).
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Robbin, will you need your tattoos touched up afterward. Please let us know how things work out. I am also thinking I might want nipples, but have been enjoying wearing spaghetti straps and hatters braless. Hubby doesn't care one way or the other, but it just seems I'm still missing something
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Well, I had my nipple recon scheduled for September 12. I changed my mind and cancelled it. After I saw my PS and decided to do it, I kept thinking about what he had said to me. I have a keloid scar on one side of my right breast, the non-cancerous side. The other scars are hardly apparent. He said he would make the incision vertically instead of horizontally. Well, that would be a nice looking cross scars. I know they flatten and can also make more scar tissue. My results are so good and I don't want to screw anything up. I have decided to just wear my pink perfect silicone nipples when I want them and then not wear them when I want to be free!.
Robin
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Hi all - this is the first time I have posted to this topic. I had my tissue expander exchange on Friday and I am now exploring my options for Nipple reconstruction. I had a UMX so I am hopeful that I will be able have nipple reconstruction that matches my native breast. I have a post op appointment with my PS in two weeks. It will be helpful if I know a little more about the process and different types of nipple reconstruction before I discuss it with PS. Any advice on what to ask PS? What is the timeline from exchange surgery until nipple reconstruction can happen. I also had a lift and small implant on my native breast during exchange surgery. Will I need anything done to the native breast nipple?
Any thoughts or comments would be great!
Laurie
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Lunderwood---I had a UMX as well as a lift/augment to my native breast at my exchange surgery. I had my nip recon 9 months later but only because that was the time frame that worked for me. I believe my PS said he could do it 2 months after exchange surgery. He did the flap type recon. I call it the origami where he uses your own skin and just twists it into a nip. Sounds awful but it's not. Really easy procedure. Took about 45 minutes and we were chatting through the whole thing. Never hurt. I then did a Vinnie tattoo 6 months later but again that was just timing that worked for me. I think my PS said he liked to wait 3 months after nip recon. And Vinnie is hard to get a appointment with so you have to plan ahead. My PS offered to do mine but once he saw Vinnie's work and then went and looked at his website, he now suggests to all his patients to "get a Vinny" if they can do it.
One thing, my PS said to pad my new nip for about 6-8 weeks. I padded it for 3 months and I have to say it's stayed a pretty decent size....not too big and not too small. He said if I wanted he could "plump" it up in a really easy procedure but I'm pretty happy with what I have. When I glance in the mirror after a shower, I don't even notice the fake nip. My PS did a great job of balancing my out and creating the nip.
Oh, and once I had the exchange surgery, I didn't need anything else done to the native side. Well, I say nothing but I had the "donut" incision around my areola and the end piece of the sutures never dissolved so I had to be put under for a few minutes so he could remove it! Just another excuse for a really good nap!!
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lala- thank you for sharing your experiences. Your diagnosis was so similar to mine. It truly helps to know what is coming next. Did your PS do the nipple procedure in his office or was it done in a hospital setting? I will discuss the "orgami" style reconstruction at my postop visit with PS. Did he use skin and tissue from the breast or from somewhere else on the body?
I am amazed at how realistic the nipple tattoos can look. I have heard about Vinnie. I wonder if insurance covers nipple tattoos?
It's good to hear that the poor native breast won't need much more after this reconstruction surgery. Right now most of my post op pain, swelling and drainage is due to the procedures on the native breast. For whatever reason I have had a higher pain level after this surgery than the UMX. All bearable of course with pain meds. (I did not need any pain meds after the UMX).
Thanks again for all the great info!
Laurie
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He did the procedure at this office but in the surgical suite instead of one of the regular exam rooms. It was done using my own skin. He just made a couple of incisions so it looked almost like a space ship (!) and then "origamied" it in place. He did numb me but only just in case since I have no sensation in that boob. Barely any blood.
Insurance did not cover my tattoo with Vinnie. Maybe it does for other people. I paid $600 for one but doubt those prices are still good.
I didn't have any drains or anything after exchange surgery. I was up a zooming around within about 4 days so I got pretty lucky.
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I'm anxiously awaiting my nipple reconstruction this Friday. I've put it off for awhile because I was just so tired of medical procedures, but now I'm ready. My first PS was going to do the origami style. He moved, so I have a new guy. He didn't give the procedure a name, but he said he will take a skin graft from the scar line of my side boobs and make areolas and nipples. Hope it turns out as good as the pictures he showed me. I recently started wearing the rub on nipple tattoos to prepare myself for the new look. I was surprised at how real they looked in the mirror.
I'm still undecided about where to go for the permanent tattoos. Vinnie isn't that far, so I could go there, but he sure charges a lot. $800 for two and it only takes about an hour. Both my PS and BS recommended a local artist who charges only $200, which sounds a little more reasonable.
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Debiann--To help make your decision on tattoos, why don't you meet with your local person? And I'm sure he/she has some pictures of results to show you. My PS said his folks couldn't do as good a job as Vinnie but a big reason is because they use a different sort of ink that fades over time. He said you usually need a touch up every 6 or 7 years. Apparently Vinnie's tattoos are pretty much lifetime because of the type of ink he uses. I'm sure you could talk to your local person and find out the details of the procedure. Maybe that would help you decide if you want to spend the money on Vinnie.
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The local person they recommended is a tattoo artist, just like Vinnie, so I'm sure it would be the same type of ink. I could get the tats at the PS office free through insurance, but they are the medical grade ink. The girl they are recommending has a shop called
"The Electric Cheetah". Its in Bethlehem, PA. Anyone hear of her? She does regular tats, permanent makeup and works with some of the local PS's on nipples. I saw pictures of her regular tats, they are beautiful, but I haven't seen any nipples.In case anyone is interested in trying the rub on tattoos, I got mine from www.nippletattoos.com. $22 (no shipping) for a set of 6.
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Debiann - I used a Philadelphia area tattoo artist, Mandy Sauler, who works with my plastic surgeon (UPenn). She was great! I am more than happy with her work. Vinnie couldn't have done a better job and she cost half as much as he did. She did the tattoos right in the plastic surgeons office, which was extremely convenient. Her bedside manner was so reassuring and her art was excellent. It was a great experience. Apparently, I could have gotten insurance to pay since the work was done in the office. I didn't follow through with the claim though. Mandy works with a number of different PS and travels to New York City a few days a week to do cosmetic tattooing.
https://www.linkedin.com/in/mandy-sauler-98931929
I think you would be very happy using someone local. As long as they understand the art and have had experience, they should be fine. No need to travel out of state.
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Today was nipple day! So happy to be finished with surgeries. My new PS did a lot more than nipples. Despite having two previous revisions, my left foob had a funky shape which he fixed (yeah!). He worked on the side boob area too. The skin for the areola and nipple flap came from the hip area along the scar line from the DIEP. He did some liposuction and smoothed out the love handles. The nipples have "donuts" sewn over them so I don't know what they look like. The big reveal is a week away. I can't wait.
As much as I don't like being all cut up and bruised again, I think the final result is going to be great.
Only glitch in the day was that during surgery my blood pressure dropped really low (into the 40's). They said it was from the anesthesia and it came back up as soon as they backed off on the gas. All is OK now, but scary to hear that it happened.
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I had so called nipple reconstruction a while after my implant in 1997. It didn't work. Started out with small nipple but as healing went on it just flattened so you see this very light outline of nipple and nipple itself flat ! Then they said well we will tattoo it to look darker at least wrong, the color did not take.
A couple years after I asked anyone who had this if it was ok. Nope three said didn't work so I had what was there removed . Remember that was a long time ago. I am going to ask my new ps who I know is smarter it he can do anything .
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Can anyone recommend a plastic surgeon in NYC that does nipple reconstruction after radiation? My surgeon is near refusing because I had radiation before my reconstruction and I'd really like to gst a second opinion. Thanks!
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I highly, highly recommend Dr. Christina Ahn in NYC. She did my nipple reconstruction after radiation. Note I had multiple fat grafting surgeries with her prior to the nipple recon, which helped the quality of my tissue significantly. It still took a very long time for my nipple to heal, but it did heal quite nicely.
Dr. Ahn is incredibly devoted to her patients.
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Nickel,
I saw Dr. Greenspun and Dr. Earhardt. Dr. Ahn was also recommended to me by my BS. I'm only five weeks out from my nip and it has flattened some. But it still looks and feels like something is there! Good luck to you.
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Thank you ladies! Really appreciate the recommendations.
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Sigh, none of these recommended docs take my insurance! Such a bummer. Does anyone have any other recommendatikns
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Hi everyone
I have some newer options to share with you about nipple reconstruction that I am still waiting to be completed.
I had a skin saving nipple saving mastectomy after chemo and no radiation. I cleared with 95 percent and the radiation reccmomendion was 98 percent or better to not need it. I met with head of radiation 3 times and he could not justify the need to treat me in light of my reconstruction goals and the blind clinical trial of women opting out of radiation. I did not qualify for the trial but did not need to in order to follow the treatment plan that is best for me and my quality of life.
I went through 4 harsh consults before finding anyone qualified to perform the procedure I wanted that won a Gracie award for the doctors who shared their innovative new surgery techniques here on this site for more doctors to learn how.
The double mastectomy was done by my oncology surgeon and plastic surgeon at the same time. I had both organs removed and maxim temp saline implants inserted. My nipples were removed and cleared of the calcification damage and cancer directly behind structure then banked just below my c section scars.
The nipples lost some depth but overall took well and will be shaped and replaced when the permanent implants are put in.
The mistakes that were made I would like to clarify freely here to save any other woman the agony of uninformed risks I never thought to even ask about while considering my whole diagnosis and my ability to endure that after the harshest chemo treatments were done. If I had a choice I would have done surgery and reconstruction FIRST giving me the best chance to heal before chemo.
The grafting process did work better than anticipated but not how they were wrapped post surgery let alone where they were placed. the fact that my pubic hair would regrow underneath the nipple grafts causing excising of infected ingrown hairs through the grafts is horrifying and very painful.
The necrosis I suffered on the top height of my nipples was caused by two golf ball size dressings too tightly stitched on top of nipple grafts then left for a week before removing them for dressings I could change as often as needed. The skin shed several times but came back the same color and nerve sensitivity of my nipples as before with almost a quarter inch depth overall except in middle where I lost tissue down to pre graft skin.
It will be properly shaped and repaired using minimal fat grafting from c section site to restore lost depth. I was told the skin below my grafts could also be used to reconstruct if more tissue was needed. Knowing what I know now I will demand only skin above public hair growth be used only! Such a simple error can truly destroy a person and I only want to spare as many others I can the horror I was faced with when I agreed to one thing and got nothing but the run around and my sanity challenged when I had severe complications that could have easily been avoided.
The complications I had were extremely hard to deal with psychologically and I highly recommend therapy during the waiting process because I am still stuck waiting for now despite completely healthy grafts and all tissue with minimal scars.
The plastic surgeon is now demanding I sign a liability waiver contract and pay out of pocket costs my insurance covers before she will agree to complete my reconstruction as initially contracted and paid to do.
Bottom line is cancer reconstruction is very different than healthy Women’s breast augmentation work so be sure to check how long your doctor had been in practice with cancer reconstruction specificly and what procedures they are verified able to perform by seeing photos of their completed patients work before you agree to be a patient.
Never be afraid to seek a second opinion if you feel something is wrong and PLEASE report to the medical ethics board anyone willing to put their profit margin over your health and welfare by dismissing your concerns instead of answering your questions professionally
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Just wanted to give a little information on nipple tattooing after reconstruction. I am a 20+ year tattoo veteran. I've seen patients that said their surgeon recommended tattooing 3 months after their surgery. As a tattooer, I recommend that we wait a minimum of 6 months. Even then, I do a free consult on my clients to make sure their skin is healed enough for tattooing. Please please don't let anyone tattoo your new nipples in under 6 months. Having tattooing done too early can create more scar tissue and a terrible healed result. If you have questions or would like to see photos of my work, check out my site at https://www.paramedical-tattoo.com
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Has anyone had their reconstructed nipples reduced or removed?
I'm almost 2 weeks out and I HATE them. They are so huge and creepy looking and show through almost every shirt I own. I don't want to have to wear padded bras all the time. I loved that I was able to go braless before this surgery. I was hoping for just a little bump but nothing like these tree trunks. Help
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Palimom, - I don't know what type of procedure you had, but I had the same reaction when my nipple recon was first done. I was VERY disappointed and upset, - but they got MUCH better (smaller and less prominent) as time passed! Hang in there, - I bet you will see that, too!
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Palimom - mine were also big and I hated them. But they did go down a lot. Now I have little bumps that aren't really noticeable if I go braless. I also got the 3D nipple tattooing done as well at a much latter date. Give it more time, you will see a difference.
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HappySpring13 and AnotherNYCGirl
Thanks for the encouragement. I have been relatively happy with the reconstruction up to now and it would be sad if the whole thing were ruined at the end (so to speak 😉).
How long did it take for your fipples to reach their final size?
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Ditto on the flattening out. Usually they flatten to nothing. Don’t worry they could easily revise if they didn’t, but doubt that will be the case!
You need to look at them 3 to 6 months out!
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Nipple recon HAS to be VERY long at first or they will flatten to nothing. Mine looked ridiculous at first and I was worried. My PS assured me that if they didn't flatten enough he could revise them but he had never had to do that. He was right, they're perfect now.
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