Nipple saving mastectomy or not?

You may not be interested but I have read there are nipple tattoos. My breasts are flat and the scars are hard to see. I am older. It is probably different at your age.

One of my girlfriends had a nipple created by a plastic surgeon later and they tattooed for color.
She is very happy with it, just be aware that either way, there may not be any sensation.

I had a nipple-sparing bilateral mastectomy in October 2024 and I immediately got tissue expanders for reconstruction.

It is my understanding as a layperson that the plastic surgeon who does this procedure has to be specifically trained to do it. Also, other factors regarding your position and type of breast cancer are part of the equation.

I like my outcome very much. My next reconstruction surgery is next month. However, I was also fully prepared to go the tattoo route. I know several women who have them and they are satisfied with their outcome.

I had a single mastectomy (left side) and nipple sparing. They biopsied the skin under my nipple and found it clean so I kept it. I am glad I did. I don't really have sensation so either way it's not going to be the same. It's a lot to handle and hard to imagine the after part until you're there. What is your surgeon telling you?

I wouldn't recommend saving the nipple. I had a class mate do that and now 2 yrs later she is dealing with cancer again. Artificial all the way.

I had a skin sparing, nipple sparing, bilateral mastectomy Jan 7, 2025. I did opt for reconstruction, I have a muscle
flap graft and small expander on the left and an expander on the right. I had my 4 week post op today, my nipples are completely healed and they look good, the right one actually has feeling, the left doesn’t, but I had radiation on the left side before my mastectomy which damaged the nerves. You can have nipples added later or tattooed. It’s really a personal decision. As long as your skin is in good condition and the cancer cells aren’t close to your nipples you should have the option to keep them. Were you planning to just have an aesthetic flat closure with nipples? If so you need to find a plastic surgeon that is skilled with that type of surgery. They can do that, or they can put a small layer of tissue or fat to create basically a barely “A” cup.

Hi, I’m glad everything is going well for you. I’m doing a prophylactic mastectomy in April, I have a very strong family history of breast cancer. I’m doing nipple and skin sparing and they will try to preserve some of the nerves (“new” techniques surgeons are trying now to preserve some sensation) my question is how did you regain sensation on your right nipple so soon? Cause my two surgeons keep reminding me that it could take almost years for me to recover some sensation on my nipple/breast, so there’s no guarantee. Your comment gives me hope. I’m grateful that my biopsy came back ok, but I’m 47 y/o and I don’t want to go to the experience again of waiting to see if it was cancer or no. So even though I’m scared and nervous I’ve decided to be bold and do the mastectomy with reconstruction and I’d like to at least get some sensation as well….

Hi @vpq - I had a nipplesparing mastectomy October 23, 2024. I just had my tissue expanders removed two days ago. Implants inserted and lipo around my stomach to get fat for breast smoothness.

I noticed a month ago that my nipples started responding to cold air, which means nerves connected and regenerated after my mastectomy. It was not something the surgeon had “promised” but she was not surprised when she saw them.

Thanks for replying, again your response gives me hope, wish you all the luck!!!

Hi @vpq, after a few biopsies in the last two years (ALH, PASH, microcalcifications, among others) and have strong family history, my sister had DCIS at the age of 36. I decided to do the prophylactic mastectomy and nipple sparing with reconstruction. I don't want to continue with the biopsies every time I do a mammogram and/or MRI. It is so stressful.
I wish you all the best!!!