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Nipple/areola reconstruction

CPT4 code

Name of the Procedure:

Nipple/areola reconstruction, nipple reconstruction, areola reconstruction.

Summary

Nipple/areola reconstruction is a surgical procedure to recreate the nipple and areola on a breast that has been reconstructed, often after a mastectomy. This procedure typically involves using local tissue to form a new nipple and may include tattooing to recreate the areola's color.

Purpose

The procedure addresses the absence of the nipple and areola following breast reconstruction surgery. The goal is to enhance the breast's appearance, restore symmetry, and improve patient self-esteem and body image.

Indications

  • Patients who have undergone mastectomy and breast reconstruction.
  • Desire for a more natural-looking breast.
  • Patients in good overall health with realistic expectations.

Preparation

  • Consultation with the surgeon to discuss options and expectations.
  • Pre-operative instructions may include stopping certain medications or supplements.
  • No fasting typically required unless additional procedures are planned.

Procedure Description

  1. Marking: The surgeon marks the desired location and size of the nipple and areola on the reconstructed breast.
  2. Nipple Formation: Local tissue is typically used to create a small mound that looks like a nipple.
  3. Areola Creation: Tattooing is often done later to add color and simulate the areola.
  4. Closure: Surgical site is closed with fine sutures.

Tools and equipment may include scalpels, needles, and tattoo instruments. Local anesthesia is commonly used.

Duration

Typically takes 1 to 2 hours.

Setting

Performed in an outpatient clinic or hospital surgical center.

Personnel

  • Plastic surgeon
  • Surgical nurse
  • Anesthesiologist (if needed for sedation)

Risks and Complications

  • Infection
  • Bleeding
  • Asymmetry of the nipples
  • Discoloration or fading of the tattoo
  • Scar formation
  • Potential need for revision surgery

Benefits

  • Improved cosmetic outcome of breast reconstruction.
  • Enhanced self-confidence and body image.
  • Realized benefits typically seen within a few weeks post-procedure.

Recovery

  • Immediate post-operative care includes wound care and managing minor discomfort.
  • Patients usually return to normal activities within a few days.
  • Follow-up appointments to monitor healing and perform areola tattooing if needed.

Alternatives

  • 3D nipple tattooing without surgery.
  • Prosthetic nipples that adhere to the skin.
  • Pros of alternatives include non-invasive nature; cons include less permanent results and possible need for frequent replacements or touch-ups.

Patient Experience

During the procedure, patients might feel some pressure but pain is minimal due to local anesthesia. Post-procedure, there might be slight discomfort, bruising, and swelling, managed with over-the-counter pain medications. Healing generally proceeds quickly with minimal restrictions on activities.

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