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    Follow-up treatments after breast reconstructive surgery

    Getting Ready to go home | Postoperative Exercises | Drains | When to call your Surgeon | The Road to Recovery | Follow-up Treatments | Resources

    Self Breast Examinations & Mammograms

    Self-breast examination should be performed on both your reconstructed breast and natural breast on a monthly basis. Ask your Breast Surgeon or Oncologist when to start and how to perform this exam on your reconstructed breast.

    Contact the CPMC Breast Health Center if you have never performed a self-breast examination.

    An annual mammogram of your natural breast is recommended, starting 6 months after any surgery to this breast. Check with your Breast Surgeon or Oncologist regarding the need for any imaging (CT scan, MRI) to your reconstructed breast.

    Further Cancer Therapy

    If further treatment is needed, contact your Oncologist to discuss the possibilities of radiation or chemotherapy, or a combination of both. Your Breast Surgeon will discuss your Pathology results with you and explain their significance.

    If chemotherapy and/or radiation are recommended, this will usually start six weeks or more after your breast reconstruction. Your Oncologist will usually wait until your Surgeon gives permission to begin therapy.

    Nipple and Areola Reconstruction

    Nipple and areola complex reconstruction are generally performed three to six months after breast reconstruction when the breast area has healed and has taken its final shape and position. NAC reconstruction is considered same-day, outpatient surgery under local or a short general anesthesia.

    The nipple and areola complex reconstruction involves two components:
    • nipple prominence

    • areolar circle

    Sometimes the nipple reconstruction is performed first, with the areola done at a later date; at other times, they are performed together.

    Nipple reconstruction usually involves a local flap procedure where wings of tissue (skin and fat) from the breast reconstruction itself are rotated in place to create a nipple prominence. Some Surgeons also add some additional tissue inside the local flaps (soft or firm) to try to improve projection of the nipple reconstruction. After surgery, the nipple reconstruction is expected to shrink between 30% and 50%. The ideal nipple prominence matches a natural nipple at rest. It will not be able to become erect with stimulation or cold temperature.

    The areola circle can be made using either a medical tattoo or a skin graft. Natural, flesh-colored medical tattoo pigments (ranging from tan, to pink, brownish, or black) are available and can be mixed together to very closely match a natural nipple and areola. The nipple prominence is also tattooed to match the other side. Tattooing can be done either in the operating room or in the office of your Surgeon under local anesthesia, and is usually done by the plastic surgeon.