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A Guide to Prosthetic Nipples and Tattooing after DIEP Surgery

After undergoing DIEP breast reconstruction, you may consider prosthetic nipples or nipple tattoos to achieve a more natural-looking appearance. While nipple reconstruction is an option, many women opt for these non-surgical alternatives for their convenience and realistic results.

Prosthetic nipples and nipple tattooing provide choices to recreate the look of the nipple-areola complex following DIEP breast reconstruction surgery. In this blog, Sydney Specialist Plastic Surgeon Dr Bish Soliman explores these methods, helping you understand the procedures, find qualified professionals, and make an informed decision aligning with your desires for your reconstructed breasts.

Nipple Procedures after DIEP Flap Surgery

After undergoing a DIEP flap breast reconstruction, nipple reconstruction is usually the final stage of the process. It aims to recreate the appearance of the original nipple and areola, providing a more natural-looking result. Here are some points regarding nipple procedures following DIEP flap surgery:

  • Nipple reconstruction is usually performed as a delayed procedure, usually 6 months after the initial breast reconstruction surgery. This waiting period allows the newly reconstructed breast to heal properly.
  • The procedure can be done as an office procedure or incorporated with a revision of the reconstruction in the operating room. It involves using tissue from the newly created breast or other body parts to rebuild the nipple and areola.
  • Tattooing may be done after nipple reconstruction to match the colour and create the areola, aiming to achieve a natural-looking appearance.
  • It’s important to note that the reconstructed nipple will not have sensation or the ability to change with temperature, and it will lack erogenous sensation.

There are two main approaches to nipple reconstruction:

  1. Immediate Nipple Reconstruction: In this method, the nipple is reconstructed simultaneously with the DIEP flap breast reconstruction surgery.
  2. Delayed Nipple Reconstruction: This is the more common approach, where nipple reconstruction is performed as a separate procedure several months after the initial breast reconstruction surgery.

While both immediate and delayed nipple reconstruction techniques are viable options, Dr Soliman only performs delayed nipple reconstruction and recommends waiting at least 6 months after breast reconstruction surgery before proceeding with nipple reconstruction or nipple tattooing. This allows for proper healing and ensures the best possible outcome.

What Is Nipple Reconstruction Surgery

Nipple reconstruction is a surgical procedure that aims to recreate the appearance of the nipple and areola after breast reconstruction or mastectomy. The main aspects of nipple reconstruction surgery are:

  • Timing: It is usually performed as a separate procedure, several months after the initial breast reconstruction or mastectomy. This allows the newly reconstructed breast to fully heal before nipple reconstruction.
  • Techniques: There are various techniques used including Skin Flap Technique – Dr Soliman creates a new nipple by making a star-shaped incision and manipulating the surrounding skin to form a raised nipple projection, Skin Graft Technique – a portion of skin from another area of the body, such as the inner thigh, is used to create the new nipple and areola and Nipple Sharing – if one natural nipple remains after a mastectomy, a portion of it can be used to reconstruct the other nipple.
  • Areola Reconstruction: After the nipple reconstruction, tattooing can be performed to create a realistic-looking areola, matching the colour and size of the natural areola or the reconstructed nipple on the other breast.
  • Outpatient Procedure: Nipple reconstruction is usually an outpatient procedure performed under local anaesthesia with sedation, with a recovery period of 3-7 days.
  • Risks and Considerations: Potential risks include tissue breakdown, nipple flattening over time, poor positioning, swelling, bleeding, scarring, and infection. Proper aftercare and protection of the reconstructed nipple during the healing process are crucial.

The goal of nipple reconstruction surgery is to achieve a natural-looking appearance and restore the shape and dimension of the nipple-areola complex.

Nipple Tattooing after DIEP Flap Surgery

Nipple tattooing is a popular non-surgical option for recreating the appearance of a nipple and areola after breast reconstruction surgery. Here are some points about this procedure:

  • 3D Nipple Tattoos: Experienced tattoo artists can create highly realistic-looking 3D nipple tattoos that appear raised but are flat to the touch. These tattoos can create a natural-looking nipple and areola without the need for surgery.
  • Timing: It’s recommended to wait 3-6 months after breast reconstruction surgery before getting a nipple tattoo. This allows the skin to heal properly and ensures the best results.
  • Process: The tattooing process takes about 30 minutes per nipple. It’s usually done by experienced tattoo artists, either at a plastic surgeon’s office or at the artist’s studio.
  • Benefits:
    • Less invasive than surgical nipple reconstruction
    • Can add fine details and colouring that can’t be achieved with surgery
    • Usually done 4+ months after other reconstruction procedures
  • Risks: Potential risks of nipple tattooing include allergic reactions, infections, granulomas, and keloids. However, these risks are generally low when performed by a skilled artist.
  • Cost: The cost of nipple tattooing after DIEP flap surgery in Sydney can vary widely depending on several factors, including the expertise of the tattoo artist, the complexity of the procedure, and the specific clinic or medical facility. Generally, patients can expect to pay anywhere from AUD 400 to AUD 1,000 for professional nipple tattooing in Sydney. It’s important for patients to consider the qualifications of the tattoo artist and the quality of the pigments used, as these can greatly affect the results and safety of the procedure.

In addition to permanent 3D nipple tattoos, temporary nipple tattoos that last 1-2 weeks are also an option for those considering nipple reconstruction.

Prosthetic Nipples

For those considering non-surgical options, prosthetic nipples offer convenient alternatives to recreate the appearance of the nipple-areola complex following DIEP breast reconstruction. These prosthetics are usually made from high-grade silicone and are designed to mimic the appearance and colour of natural nipples, providing an aesthetically pleasing option for those who may not be ready or do not desire further surgical interventions or tattooing.

One of the key benefits of silicone prosthetic nipples is their ease of use. They can be securely adhered to the breast using special adhesives, which ensures that they stay in place throughout the day but can still be easily removed without discomfort. This feature is particularly appealing for those who are seeking a temporary solution during their post-surgery recovery phase or for women who prefer to avoid permanent alterations.

The realistic look that these prosthetics offer is a significant advantage. Manufacturers of silicone nipples have refined their techniques to create products that closely resemble the natural look and feel of real nipples, including variations in colour and texture that enhance realism.

The cost of prosthetic nipples in Sydney can vary based on several factors including the quality of materials used, the customisation level, and the provider. Typically, prices for these silicone prosthetics might range from AUD 300 to AUD 500 per nipple. Customisation options, which can include specific pigmentation to match your skin tone and unique texturing to mimic the natural look of a nipple, can be factors that influence the final cost.

Dr Soliman recommends ProCosmediq, a leading clinic located in Sydney, for women seeking nipple and areola tattooing as well as prosthetic nipples. ProCosmediq specialises in offering realistic, high-quality cosmetic solutions for those who have undergone reconstructive breast surgery, including the DIEP flap procedure. At ProCosmediq, patients can expect to receive services that are tailored to meet their specific aesthetic needs, provided by a skilled professional experienced in medical tattooing and prosthetics.

FAQs about Prosthetic Nipples and Tattooing after DIEP Breast Reconstruction

What are prosthetic nipples and why might someone choose them after DIEP breast reconstruction?

  • Prosthetic nipples are artificial nipples made from silicone or other materials that can be adhered to the breast after reconstruction surgery. People choose prosthetic nipples as they provide the appearance of a natural nipple without additional surgery. This can be an appealing option for those who prefer not to undergo further procedures or who want a non-permanent solution.

How does nipple tattooing differ from prosthetic nipples?

  • Nipple tattooing is a process where permanent ink is used to create the appearance of a nipple and areola on the reconstructed breast. Unlike prosthetic nipples, tattooing is permanent and can offer a more realistic look without the need for daily maintenance. Tattooing can also add depth and dimension to the breast, which prosthetics cannot.

How soon after DIEP breast reconstruction can nipple tattooing be performed?

  • Nipple tattooing is usually recommended after the breast has fully healed from reconstruction surgery, which can take several months. Dr Bish Soliman advises waiting at least 3 to 6 months post-surgery to ensure the swelling has subsided and the skin has stabilised, providing a better canvas for tattooing.

What should I consider when choosing between prosthetic nipples and tattooing?

Considerations include:

  • Desire for permanence: Tattooing is permanent, while prosthetics can be removed or changed.
  • Sensitivity and pain tolerance: Tattooing involves some discomfort, similar to traditional tattooing, whereas prosthetics do not.
  • Aesthetic preferences: Some find that tattooing offers more realistic results.
  • Health conditions: Skin conditions or poor healing might affect the choice.
  • Lifestyle: Active lifestyles might favour tattooing to avoid the risk of prosthetics shifting or coming off.

Are there risks associated with nipple tattooing after DIEP reconstruction?

  • The primary risks include infection and allergic reactions to the ink. There’s also a risk of poor aesthetic outcome if the ink fades or spreads over time, which can be affected by the skill of the tattoo artist and the healing process of the individual.

How do I care for my nipple tattoo to ensure the best results?

  • Aftercare for a nipple tattoo is similar to that of a regular tattoo. Keep the tattooed area clean and moisturised, avoid direct sunlight, and refrain from submerging the area in water (such as swimming pools or bathtubs) until fully healed. Following your tattoo artist’s specific aftercare instructions is crucial for the best results and longevity of the tattoo.

Can prosthetic nipples and tattooing be combined?

  • Yes, some individuals choose to combine both methods to achieve their desired aesthetic. Prosthetic nipples can be used initially while deciding on permanent tattooing or while waiting for the surgical area to heal sufficiently for tattooing.

Further Reading about DIEP Flap Surgery with Dr Bish Soliman

Medical References about Prosthetic Nipples and Tattooing after DIEP Breast Reconstruction

About Dr Bish Soliman

Dr Bish Soliman - Sydney Plastic and Reconstructive Surgeon, about us 01 2x
Specialist Plastic, Reconstructive and Cosmetic Surgeon
FRACS (Plas), MS (Plas), MBBS (Hons 1), BCom

AHPRA Registered Medical Practitioner MED 0001679053 Specialist Registration in Plastic Surgery

Dr Bish Soliman is a Sydney-based Specialist Plastic and Reconstructive Surgeon who performs aesthetic surgery of the face, breast, and body as well as skin cancer surgery.

He currently holds two consultant microsurgery positions in major Sydney hospitals performing complex microsurgical reconstruction including DIEP breast reconstruction.

After graduating from The King’s School, Dr Bish completed a Bachelor of Commerce degree at the University of Sydney. After working briefly at a major Sydney finance firm, he decided to pursue his passion and long-term goal of a career in medicine. He graduated from the University of Notre Dame at the top of his class, receiving First class honours and the prestigious Bower and Sherrard medal. He then went on to complete his junior medical training at Westmead Hospital during which time he was awarded Junior Medical Officer (JMO) of the Year, as well as a finalist for NSW Doctor of the Year.


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