Nipple and Areolar Reconstruction (NAR) Post-Operative Instructions

Instructions

Nipple Areolar reconstruction is done at least 3 months after a Reconstructed Breast has been achieved.

• NAR reconstruction is done as an Outpatient.
• Patients may return to work in two weeks.
• You must be off of pain medication before returning back to work.

When you wake up from surgery you will have a bolster over your Nipple graft. This bolster looks like an old fashioned pin cushion. The bolster is sutured to your breast and must be kept dry. The purpose of the bolster is to hold the graft in place. You do nothing to this area until your first Post-op appointment. The appointment will be 5- 7 days after your surgery. It may not necessarily be your physician's clinic day. If it is a day other than your physician's day to be in clinic, you will be seen by the nurse. The nurse or medical assistant will be removing your bolster. Sutures around the areola will be left in one week later. You will be given instructions and supplies to care for your grafted areas until your next clinic appointment. At the second post-op visit sutures around areola will removed.

If your first Post-op appointment happens to be the same day that your physician's is in clinic; the bolster and all steri strips will be removed by the nurse. Once your surgeon has seen you, instructions will be given to remove and clip any sutures. The nurse or medical assistant will teach you how to dress the graft sites.

You may shower after the bolster is removed. No hot tubs or baths at this time. Do not allow water from the shower to directly hit the breast. The shower water may be directed on your back. You may shower with soap and water. Allow your nipples to air dry. Completely cover areola and nipple with Xeroform, Apply 4x4, Tape securely. You may start wearing a bra.

Reconstruction of the areola is most often achieved with a full-thickness skin graft. Donor sites include the following:

• The TRAM abdominal incision
• Medial thigh
• Breast Mastectomy scar

These donor sites will have a steri strip over the incision. Leave the steri strip in place until you return to clinic. Sutures used for this operative area are dissolvable. You may remove the gauze dressing after 48 hours.

For Medical Questions, Please Call:

• (734) 998-6022, Monday - Friday, 8 a.m. - 5 p.m.
• After hours and on weekends, call Hospital Paging at (734) 936-6267 and ask for the Plastic Surgeon on call.