A topic that frequently comes up in the Sisterhood of Support groups is the reconstruction of the nipple and subsequent nipple tattoo. While the majority of women don't think twice about having it done, there are a sufficient number who express hesitation when confronting nipple areola reconstruction. If one hasn’t had nipple-sparing surgery as part of their initial mastectomy, nipple areola reconstruction surgery completes the total aesthetic objective of breast reconstruction after mastectomy. While the decision to undergo secondary procedures is difficult for some, we hear from so many of our patients about the positive effects of their decisions to have nipple areola reconstruction. In fact, studies have shown that the re-creation of the nipple areola complex has a high correlation with the acceptance of one’s body image and is highly important to the psychological health of the patient. That being said, we respect this sensitive decision and personal choice.
In my many years of experience working with breast cancer patients, the reluctance tends to fall into two categories: 1. A woman is feeling worn from the process she has undergone since diagnosis and this final stage is perceived as ‘one more surgery’ 2. Some women enjoy the freedom of not wearing a bra, post reconstruction, and do not want to be concerned about the presence of a nipple through clothing.
Three “SOSers” were delighted to share their emotions surrounding their decisions to undergo, or not undergo, nipple areola reconstruction:
To Nip or Not…there is no question! Absolutely!!!!! After my implants were placed I never wanted nipples...I wanted the whole ordeal to be over. It took me awhile to deal with my ambivalence; I came close many times to my surgery date and then would find a reason to cancel. The women in the Sisterhood of Support groups encouraged me, cheered me on and even ‘flashed’ me. So, I finally got my nipples and I would do it all over again. To look down at yourself and feel complete is a satisfying feeling. I finally feel like myself again. Imagine opening a present how do you feel?? Excited, happy. When I saw my nipples it was like opening a gift. I was back to feeling like a woman again. I was complete!
(Note: This patient left a message on my voice mail the day after nipple reconstruction that said – “I looooooooooooooooooooove my nipples”.)
Before Nipple reconstruction I felt incomplete and not whole. I would cover up and didn't like to look in the mirror. My self-confidence was low and I was not feeling good about myself.
But, as soon as I had the nipple reconstruction, my self-confidence started to return and I began to feel WHOLE again. When I completed the final step which was the tattooing my full self-confidence returned! I finally felt complete and feminine again. I was no longer covering up – I was BACK and even better!
For me, the decision not to have nipple reconstruction and tattooing was an easy one. After having a double mastectomy where my breasts were reconstructed using the fat from my lower abdomen (DIEP flap). I have so many scars; I have trouble looking at myself in the mirror.
I have always had a positive attitude, so I decided to turn what I disliked into a work of art, which is my passion. I want to look in the mirror and feel beautiful. I am eagerly waiting for my "masterpiece" to begin this coming December.
Clinical Director, Patient Empowerment Program