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Nipple reconstruction is an optional procedure, but for many women, it adds a more natural look to their new breast and brings closure to the mastectomy experience. Some women prefer to forego new nipples, which have no sensation and do not react to cold or touch the way natural nipples do.
Your plastic surgeon can create new nipples when your reconstructed breast has settled into its final position (about three or four months after flap revision surgery or implant exchange surgery). Nipple reconstruction is a relatively simple procedure. A small flap of skin on the front of the breast is fashioned into a nipple and sutured in place. Because reconstructed nipples tend to shrink, they are initially made up to 50% larger than the desired size. A more traditional procedure uses skin grafts from the inner thigh, labia, or back of the ear (the skin in these areas tends to be darker) to create the nipple and areola. Using a skin graft tends to scar an additional part of the body, however, and can be uncomfortable at the donor site.