A Better Way

A couple of weeks ago I mentioned prosthetics as an alternative to further surgery.  After the breast mound reconstruction is completed, nipple and areola reconstruction generally involves at least two more procedures.  The first recreates a nipple projection via grafting and/or some surgical manipulation of local skin.  It is followed months later by areolar tattooing, which can be performed by the plastic surgeon or (as my plastic surgeon recommends) at a tattoo clinic specializing in the procedure.

The first procedure requires more down time and incurs further risk for complications.  The tattoo would fade over time and need to be refreshed periodically by a tattoo artist. Because of surgical grafting limitations, the finished nipple projection maxes out at 5mm in depth, a fairly modest profile.  Unfortunately, 5mm would fall short for a decent match to my healthy left nipple.  So after all of the pain and inconvenience of more surgeries, I would be left with a poor cosmetic result.  What to do?

Prosthetics.  Thanks to the wonders of silicone, I have another choice.  Off the shelf prosthetic nipples have been available for some time, but with limited selection in terms of color, size, and shape.  Although this is a reasonable alternative for women undergoing bilateral mastectomies, it would poorly mirror my healthy breast.  Enter the custom made prosthetic nipple. Depending on the vendor, patients submit pictures, impressions, measurements, and color codes to match an existing nipple or nipples (if done before bilateral mastectomy).  The prosthesis stays in place for up to weeks at a time via a medical grade adhesive.  Here are a couple of companies that provide this specialized service:



I sent these two links to my plastic surgeon and asked him about my delaying further surgery indefinitely while I try out a custom prosthesis.  If the prosthesis ends up being less than satisfactory cosmetically or functionally or if surgical techniques someday offer a better match, I can elect to undergo surgery at that time.  Dr. Orman was not only supportive of the idea but also interested in recommending to other patients if there are no significant downsides.  Here is part of his response:  “I have to honestly say that these prosthetics look more natural and “normal” than ANY surgical nipple reconstruction I have ever seen.”

Dr. Orman did have reservations about how well the prosthesis would stay in place, but that’s exactly what I will be testing over the next few months because I am flying to Salt Lake City early tomorrow morning to meet with Paul, the owner/fabricator at customdme.  Earlier this month I emailed careful measurements and photographs to Paul so that he could create a pair (one will be back-up) of custom untinted prostheses prior to my on-site visit.  Tomorrow morning, Paul will color match and ink the prostheses in person and then cover both with a protective finish coat.  If all goes as planned, I will still have a few hours to look around Temple Square before a mid-afternoon flight back to the Bay Area.  No pain, no anesthesia, no recovery, and even some sight-seeing on the side!

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