Post-Operative Nipple Areola
One of the most rewarding parts of breast reconstruction is having the nipple and areola created. Many patients think of it as the icing on the cake. Chances are, you have probably spent the last few months getting used to nipple-less or 'Barbie' breasts. Regardless of the type of reconstruction you have had, nipples will truly give you the look of a real breast. For many women, this is the final step after a long journey. Whether you are considering having nipples created or having tattoos only, and want to know what your options are, please refer to Nipple Reconstruction.
This section will provide you with guidelines for home care after nipple surgery. The after care of your nipple areola reconstruction is dependent upon what you are having done during the procedure. If you have had abdominal flap reconstruction, your nipple areola is usually created during the second stage, at the same time as revisions to the breasts and abdomen. In an implant setting, nipples are generally created after you have healed from the final expander implant exchange surgery, to allow for optimal symmetry.
Your plastic surgeon will give you post-operative instructions, and it is essential that you follow them. Much of the success following nipple areola reconstruction depends on the after care. If your areola was created using a graft method, a plastic nipple protector will likely be sewn on during surgery, and will stay on for about a week. After surgery, you will go home wearing a surgical or sports bra which will hold the dressing and gauze. Most surgeons prefer that you keep the garment on until your next office visit, usually within five to seven days (unfortunately, that may mean no showers). At that time the dressing will be taken off, and after you are cleaned up, you will get your first look at the new addition(s).
Many women are nervous when they first see their nipples, because they don't know what to expect. The nipple will be discolored, have stitches that may or may not stick out, and be swollen. Don't despair. Just like every other stage of your reconstruction, the nipples will heal in time. Stitches may take over one month to fully dissolve, and the discoloration should resolve in the same time frame.
Once your surgeon has given you permission to shower, and take off the surgical bra, the rest of the care is up to you. It is important not to wear clothing that restricts or flattens the nipple. You may want to get gauze pads, and Bacitracin or Aquaphor ointment. By moisturizing the nipple, it will heal faster. You do not want the nipple to rub against your clothing, and compression of the nipple can be minimized by using gauze pads and some paper tape, or placing gauze inside a soft, cotton (breathable) bralette. When showering, do not scrub the nipple. Do not use harsh soap or body wash on the nipple, and avoid scented lotions. Do not engage in water activities such as swimming for four weeks, or until your surgeon gives you permission. Remember that early after surgery the nipples are delicate, and you won't have any feeling in them. If you engage in sexual activity, avoid the nipple area until everything has fully healed.
About three months after surgery, you should be ready to have the tattooing performed. If you are pleased with the color of the nipples (especially if you've had bilateral reconstruction, and don't need to match an existing nipple color) you may choose to skip the tattooing process. Most women feel an emotional boost after having nipple reconstruction, because the appearance of a real breast is now combined with the appearance of an actual nipple. For many, this is the time where you can truly get comfortable with the new you, and start to move forward.