Women Undergoing a Mastectomy Have Options to Preserve their Sense of Self
- “2nd Base Podcasters,” who are also breast cancer survivors, sport the new “Skims” bra, which gives wearers a sense of having their perky nipples again following a mastectomy.
- When the breast is removed during a mastectomy to treat breast cancer, the nipple is often removed. However, in some cases, the nipple and the area around it can be preserved in a procedure called nipple and areola reconstruction.
- Nipple tattooing is an option for women who are not able to spare their nipples during a mastectomy. Dana-Farber oncologist Dr. Ann Patridge says that by utilizing color and shading, tattoo artists can provide excellent 3D reconstructions of a nipple that appear from the front to have a papule of the nipple or the center portion of the nipple, with the surrounding color.
- Prosthetic nipples are another option for women wishing to reclaim a sense of their breasts before getting a mastectomy. They are waterproof, and the medical adhesive used with them can usually last for about a week before needing to be reapplied.
The podcasting duo “Bowman and Burks” of the Second Base Podcast are two breast cancer survivors who share stories of their journey through humor. Naturally, when word spread of a new bra that gives women the feeling of pronounced nipples, it piqued their interest.
The podcasters showed themselves wearing the bra and their ‘new’ nipples. Amid the laughter, this is a real concern for women who are faced with breast cancer and undergo breast cancer surgery, such as a mastectomy, which can affect the nipple and areola.
@2ndbasepodcast we give it a 10/10 #foryoupage #fyp #cancer #skims #skimsreview #nipplebra #kimkardashian ♬ original sound – 2nd Base
When a woman decides to have a mastectomy, several factors go into that decision. Among things to consider is whether to have breast-conserving surgery such as a lumpectomy. These decisions should be made alongside your doctor by openly and candidly discussing risks vs. benefits.
Some women decide to have their breasts reconstructed and have implants put in right after the mastectomy, while others don’t have reconstruction at all.
WATCH: Implant reconstruction after a mastectomy.
One potential side effect of getting a mastectomy involves the nipple on the breast. When the breast is removed, the nipple is often removed too. However, in some cases, the nipple and the area around it can be preserved in a procedure called nipple and areola reconstruction.
Dr. Port added that most women do opt to have some reconstruction. The length of these surgeries can vary a great deal. When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). There is also the option to take one’s own tissue (usually from the belly area) and transfer it into the breast area during reconstruction.
Helping Patients Better Understand a Mastectomy
Understanding Nipple-Sparing Mastectomy
The “Skims” bra is an option for some women who undergo a mastectomy and may not have had the option to keep their nipples. However, if you are considering a mastectomy, you should ask your doctor about nipple-sparing.
During a nipple-sparing mastectomy, doctors use special techniques to shell out a woman’s breast, leaving the skin and the nipple intact. The idea is to maintain, as close as possible anyway, the natural look of the breast. After mastectomy, a plastic surgeon will use either an implant or the woman’s own tissue to recreate the breast. When a woman’s own tissue is used, doctors typically take it from fat in the patient’s lower abdomen.
“It is certainly the ideal procedure for those woman who chose to have prophylactic mastectomy who don’t yet have breast cancer,” says Dr. Irene Wapnir, a breast surgeon at Stanford Medicine. The downside to this procedure, says Dr. Wapnir, is a loss of sensation in the nipple area.
Women Have Several Mastectomy Options Even If Nipples Cannot Be Spared
Prosthetic nipples are waterproof, and the medical adhesive used with them can usually last for about a week before needing to be reapplied. Depending in part on the frequency of wear, they can last for months or years before needing to be replaced. There are many types and brands to choose from.
A nipple tattoo is another option for women who want their breasts to look similar to before they had a mastectomy.
For many women who get nipples tattooed on their breast after cancer, they have had surgery on their breast, necessitating the want or need for a tattoo in that area.
Dr. Raheem Nazerali, a breast reconstructive surgeon at Stanford Health Care, explained the nipple tattooing process in a previous interview with SurvivorNet.
WATCH: Understanding nipple tattoos
“Nipple tattooing is generally for patients who have undergone a skin-sparing mastectomy or a delayed reconstruction. So, patients who are not eligible for nipple-sparing mastectomies can have a nipple reconstructed by their plastic surgeon,” Dr. Nazerali explains.
“Generally, I tell patients that there’s three different types. There’s a 2D reconstruction, a 3D reconstruction, and a 4D reconstruction. So, a 2D is basically just the tattoo done by either a tattoo artist, or done by a physician assistant, or an advanced practitioner, that provides color to where the nipple was supposed to be,” he adds.
“The 3D tattoo involves shading, so different amounts of shading, just like makeup, can make things look either flat or can make things look in three dimensions,” he explains. “Utilizing color and shading, tattoo artists are able to provide excellent 3D reconstructions of a nipple that appear from the front to have a papule of the nipple, or the center portion of the nipple, with the surrounding color.”
Questions to Ask Your Doctor
If you’re facing the option of having a mastectomy, here are some questions to consider asking your doctor:
- What can I do to prepare for a double mastectomy?
- What happens before and after the procedure?
- For reconstruction, what are the benefits of using implants over my own tissue and vice versa?
- What should I know about implants? Should I opt for preventative surgery?
- What will recovery look like after the procedure?
- What are the benefits of a watch-and-wait approach vs. preventive surgery?
- What kind of surveillance is required after the surgery?