We prefer to allow your reconstructed breast to "settle" for at least 3 months so that the nipple and/or areola can be placed in the proper position. Nipple-areola complex reconstruction is done usually with local anesthesia as an outpatient procedure, however, it can also be combined with further breast revisions requiring general anesthesia. Either option does not require you to stay overnight at the hospital. This procedure usually involves very little discomfort.
In this section, we will specifically discuss nipple reconstruction. Typically, if patients are interested in areola tattooing, this procedure occurs 3 months following nipple reconstruction.
Options for reconstruction of the nipple include:
- Using tissue and fat of the reconstructed breast (local flap).
- Using the opposite nipple if it is large or very pointy (nipple share).
- Using tissue from the other part of the body (labia, most commonly).
- 3D tattoo by a medical tattoo artist.
People who opt to undergo this procedure do not require a pre-admission appointment.
This procedure is most commonly performed utilizing local anesthetic in a clinic setting. If so, there are no set recommendations or restrictions the day before your procedure.
Some patients may be offered to receive this procedure by their surgeon if they are requiring further surgical revisions under general anesthesia. If your nipple reconstruction is performed under general anesthesia, please see below for the instructions on how to prepare for your surgery.
Stop eating food by midnight on the night before your operation. Your stomach needs to be empty.
-
STOP eating food by midnight on the night before your operation.
- You may drink clear fluids up to 5 hours before your operation:
- Apple juice
- Beef or chicken broth (no noodles or vegetables)
- Orange juice (without pulp)
- Grape juice
- Jell-O or popsicles
- Cranberry juice
- Pop (such as ginger ale, 7-Up, Coke)
- Lemonade
- Water
- Coffee or Tea (no milk)
Day of Your Operation
Please arrive at the clinic approximately 15 minutes before your scheduled appointment time. Our clinics are located at:
M. Lau Breast Centre
Princess Margaret Cancer Centre – 2nd Floor
Plastics Clinic
Toronto General Hospital
Peter Munk Building – 7th Floor
If you are receiving this procedure under general anesthesia, please see the following instructions.
Arrive
2 hours before your scheduled operation time:
Surgical Admission Unit (SAU)
Toronto General Hospital
Peter Munk Building – 2nd Floor
TGH Maps & Directions
All hospital entrances are open by 6 am. However, Elizabeth St. and University Ave. are easiest to access.
On this page, you can read all about what to expect during your hospital stay. Or, just click on one of the links below, to get the answer you want right now.
- You will have dressings on your surgical incisions.
- You will be given a brochure outlining how to take care of your surgical site at home and any limitations along with dressing supplies.
- Generally, since no general anesthesia is required, you will not feel any different after your procedure.
- Typically, local anesthetic is applied to the breasts to recreate the nipple/areola. However, many patients have reduced breast sensation following their previous reconstruction surgeries and require little to no local anesthetic at all.
- At home, you will be able to complete your activities of daily living (e.g., walking, toileting, getting dressed and personal hygiene).
- No hospital stay is required if your procedure is performed in a clinical setting.
- If your procedure is completed in the operating room, you can expect to be discharged the same day of your operation.
Go to your nearest emergency department if: you see these signs of infection:
- Your temperature goes higher than 38℃ (100℉) and lasts longer than 24 hours.
- If you feel chills.
- Bright red, hot and swollen incisions or skin.
- White fluid or pus that smells bad.
- Do not wear a tight bra or tight clothing over your nipple. This helps to make sure that the area does not shrink.
- You can shower 1–2 days after your surgery.
Do not wash the area where you had the surgery. You can wash the area around the wound by using a gentle soap. Try to not get any water on the wound.
- No heavy lifting or going to the gym until the stitches are removed and incisions are healed (about 2 weeks).
- Patients after this procedure are able to return to work as early as the next day.
- After your surgery, it is important to protect your new nipple. Your health care provider will put a dressing over the wound. You need to keep this dressing on for 7 to 10 days. Afterwards, you can remove the dressing yourself. Please book an appointment to have your stitches removed in 10 days.
- There are times when the dressing needs to be changed more often. We will tell you if it needs to be changed after your surgery.
- If you are asked to change the dressing, change it 1 to 2 days after the nipple reconstruction.
- Before you start, collect all the things you will need (three 4x4 gauze with a hole cut in the middle, a medicine cup, and tape).
- Wash your hands with soap and water.
- Put two 4 x 4 gauzes with the hole cut in the middle on the nipple.
- Put the medicine cup on again. Make sure it is in the right position.
- Put another 4 x 4 gauze on top and tape the sides to keep the gauze in place.
- Repeat for once a day for 4 to 6 weeks.
- You don't need to change the first layer of the original dressing (jelonet) unless you still notice some bleeding. The jelonet is the net-like dressing covered in Vaseline that prevents blood from sticking to gauze.
You will be given dressing supplies when you go home. You can also buy dressing supplies at your local pharmacy or health supply store.
Go to your nearest emergency department if you see these signs of infection:
- Your temperature goes higher than 38℃ (100℉) and lasts longer than 24 hours.
- If you feel chills.
- Bright red, hot and swollen incisions or skin.
- White fluid or pus that smells bad.
The Nurse Coordinator is your first place to call for post-operative questions:
Agnes Wisniewski, RN, BScN, MN
Phone: 416 340 4800 ext. 5161
You can also call your surgeon's office for more information.
If you have concerns regarding your breast reconstruction, please call your surgeon's office or go to the emergency department at the hospital where you had your operation.
Before you leave the hospital, you will be reminded to call your surgeon's office to schedule a follow-up appointment.
Before you leave the hospital, you will be reminded to call your surgeon's office to schedule a follow-up appointment
When
10 days after your surgery.
Where
There are two clinics associated with the Breast Reconstruction Program. We will tell you which clinic to go to when you call your surgeon's office to schedule an appointment.
Princess Margaret Cancer Centre |
Maps & Directions
2nd Floor, M. Lau Breast Centre.
Toronto General Hospital |
Maps & Directions
7th Floor, Plastics Clinic
What to Expect
Your surgeon will assess your surgical sites for their healing process and speak to you about your recovery.
Your surgeon will let you know when you should return if an additional follow-up appointment is required. You will be required to call the office to schedule this.
What to Bring
Please bring your health card to your appointment.
