Gary Trignani asks:
My wife recently had nipple sparing breast surgery. The surgeons made an incision through the nipple complex. The nipple tissue is dead and my wife now, does not have nipples. She was told from plastic surgeons, that the tissue is so far gone, she is not even a candidate for nipple reconstruction. Was it the correct procedure to make an incision through the nipple complex for a nipple sparing surgery?
On: 10/22/2013 04:43 pm
To doctors from: California
DrJamesWethe on 10/30/2013 12:42 pm wrote:
Gary- so sorry to hear that the outcome from your wife's breast surgery did not go as everyone wanted...the surgeon included. Nipple sparing mastectomy has rapidly become a very standard approach for surgery of that type. As with every operation there are both risks and benefits which both the surgeon and the patient weigh while making a decision as to exactly what form of surgery would be best for an individual patient. It would be inappropriate for me to second guess anyone involved in that decision making process with the information I have. The surgery you describe IS a common and well accepted approach for that type of procedure. Nipple reconstruction is usually possible even in more difficult cases but, again, I have limited information so I can't be more specific. Ask the surgeon to explain the options that are currently available to your wife. Take notes and don't be afraid to ask questions.
DrKourosAzar on 10/28/2013 08:47 pm wrote:
I am sorry to hear that she is having a problem. Did your wife lose the nipples on both breasts? There are many different choices on incisions for the nipple for nipple sparing surgery. Some are through the nipple, some are around the nipple. The choice of incision is not the same for all patients as it depends on the circumstances. Was this for a mastectomy or for breast implants cosmetically? We usually refer to nipple sparing surgery for mastectomy so I am going to assume that for now. In that case, if she is very thin and there is not very much tissue there to work with, what can SOMETIMES be done is to inject some fat in 1 or 2 sessions under skin and nipple to give some cushion and then perform the reconstruction. The reconstruction can be peformed with moving local tissue around (C-V flaps). I also like to insert a small piece of alloderm (human skin product) to provide some bulk to the nipple so it doesn't flatten over time. Obviously I would need to see her to be sure my suspicions are correct. Let me know if you have any other questions. I wish you both the best of luck. Dr. Azar