This information will help you prepare for your nipple and areola reconstruction using a skin graft.
A skin graft is made by taking tissue from 1 part of your body (donor site) and moving it to the surgical site that needs to be covered (recipient site). Common donor sites include the groin and lower abdomen (belly).
Your nipple will be made from the skin on your chest. Your areola (brown circle around your nipple) will be made with a skin graft surrounding your nipple.
Before Your Procedure
Before your procedure, you will have an appointment for presurgical testing (PST). The date, time, and location of your PST appointment will be printed on the appointment reminder from your surgeon’s office. You can eat and take your usual medications the day of your PST appointment.
During your appointment, you will meet with a nurse practitioner (NP) who works closely with anesthesiology staff (doctors and specialized nurses who will give you medication to put you to sleep during your procedure). Your NP will review your medical and surgical history with you. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests necessary to plan your care. Your NP may also recommend you see other healthcare providers.
Your NP will talk with you about which medications you should take the morning of your surgery.
It‘s very helpful if you bring the following with you to your PST appointment:
- A list of all the medications you’re taking, including patches and creams.
- Results of any tests done outside of Memorial Sloan Kettering (MSK), such as a cardiac stress test, echocardiogram (echo), or Carotid Doppler study.
- The name(s) and telephone number(s) of your doctor(s).
Your nurse will give you a resource called Getting Ready for Surgery, which includes important information on how to prepare for your procedure.
In addition to the information in Getting Ready for Surgery, remember the following:
- On the day of your procedure, wear a thin, nonpadded bra or a form-fitting, light-colored shirt. This will help you and your surgeon see where your nipple and areola will be placed.
- Bring loose clothing to wear home after your procedure. You don’t want to have any pressure or friction on your incisions (surgical cuts).
- If you received stickers to help your surgeon place your nipple and areola, wear them the day of your procedure.
- If you will be traveling by car after your procedure, bring a small pillow or towel to place between your seat belt and chest, to avoid the seat belt from rubbing on your incisions.
Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having procedures on the same day.
After changing into a hospital gown, you will meet your nurse. They will place an intravenous (IV) catheter into a vein, usually in your hand or arm. At first, you will receive fluids through the IV, but it will be used later to give you anesthesia (medication to make you sleep). Your surgeon will explain the procedure to you and answer any questions you have.
When it’s time for your procedure, you will be brought into the procedure room and helped onto an exam table. You will be attached to equipment to monitor your heart, breathing, and blood pressure. You will also receive oxygen through your nose. Once you’re asleep, your surgeon will start the procedure.
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After Your Procedure
When you wake up after your procedure, you will be in the Post Anesthesia Care Unit (PACU). Your nurse will continue to monitor your heart rate, breathing, and blood pressure. You will have a bandage on your chest. Don’t touch, wet, or change this bandage.
Once you’re fully awake, your nurse will give you a drink and a light snack. Your family and friends can visit you once your healthcare providers feel you’re ready.
You will get a prescription for a mild pain medication.
You will go home the same day as your surgery. Before you go home, put on the loose and comfortable clothing that you brought with you. If you will be traveling by car, place a small pillow or towel between the seat belt and your incision. Don’t let the seat belt to rub against your incisions.
While you’re recovering:
- Don’t wear any tight clothing or bra that can rub against your incisions.
- You can wear a loose-fitting bra that doesn’t compress your nipple or graft for 1 to 2 weeks after your procedure.
- Don’t apply any pressure or friction to your nipples for 4 to 6 weeks after your procedure.
Caring for your chest
Don’t touch, wet, or change the bandage on your chest.
Touching the bandage may affect the healing of your nipple and areola. Your bandage will be changed for the first time at your follow-up appointment. During that appointment, your nurse will teach you how to change your bandages. You will need to change them every day.
You may shower from the waist down or take a sponge bath for the first 48 hours after your surgery. Your incision at your nipple and areola must be kept dry. Your surgeon will tell you at your first follow-up appointment when you can take a full shower.
Your incision in your donor site may feel tender or tight after your procedure. Take the pain medication that your surgeon prescribed.
Restrictions on physical activity
If the donor site is your groin, don’t do any activity that may extend your leg beyond normal limits (hyperextend), such as squats or straddles, for 6 weeks.
Your surgeon and nurses will give you instructions on what exercises and movements you can do while your incisions are healing. Check with your surgeon or nurse before starting exercises, such as:
- Lifting weights
Your first follow-up appointment will be _____ days after your procedure.
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Call Your Doctor or Nurse if You Have:
- A temperature of 101° F (38.3° C) or higher
- Redness, warmth, or increased pain in your nipple and areola or your donor site
- Drainage or oozing from an incision
- Shaking chills
- Flu-like symptoms
- Shortness of breath
- Any type of skin infection on any part of your body