Nipple and Areolar Reconstruction with Tattoo Pigments,Grafts and Local Flaps

Abstract

JM Drever. Nipple and areolar reconstruction with tattoo pigments, grafts and local flaps. Can J Plast Surg 1993;1(2):84-90. In order to obtain symmetry when reconstructing the nipple and areola, the breast mounds are worked on first. Having reconstructed one side, the volume and shape of the opposite breast is modified as needed; then the areola can best be imitated on the reconstructed breast by placing tattoo pigments on the dermis of a thin skin graft. If the areola that is to be matched is light in colour, it is preferable to tattoo the skin directly. This is done as the initial procedure, as an improvement or as ‘maintenance’ to an already tattooed areola. The nipple reconstructed by grafting part of the opposite nipple or section of areola produces the most natural looking results. Another method involves lifting a tulip-shaped, centrally based dermis flap and then covering the areola and this flap with a thin skin graft with tattoo pigments smeared on its dermis. A nipple is made of the breast skin when the mound is revised by taking a segment off its lower quadrants.