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Reconstruction of breast areola and nipple through dermopigmentation

The area of the mammary areola is the most demanded treatment of those that are part of the paramedical group. Generally, it has a restorative purpose because it is the last stage of breast reconstruction, but it can also be purely aesthetic, that is to remedy some chromatic imperfection of the skin.
The various treatments that can be carried out on the mammary areola are:
• Reconstruct breast plaque and nipple after a full or partial mastectomy (excision) of the breast or in case of breast achromia (decrease in breast areola pigmentation).
• Subjects with congenital or traumatic malformations (e.g. childhood accidents)
• Disguise a periareolar scar after surgery of:
- additive mammoplasty (insertion of a breast implant)
- Reductive mammoplasty (breast reduction)
- mastopexy (breast lift)
- gynecomastia (breast reduction in humans)
• Correct defects or aerolar insufficiencies
• Redefine the size, shape, color or symmetry of the mammary areola.

Dermopigmentation of breast areola and nipple can only be carried out 6 months after surgery. In some cases it can be done even after only 3 months, with written permission from the surgeon.
The essential condition for carrying out the treatment is that the area to be treated is completely healed and that the scars are white and NOT pink or reddish.
Depending on the severity of the disease, in some subjects only one breast is excised (unilateral mastectomy), in others, instead, a bilateral mastectomy is carried out. In these cases, it is a good rule to involve the subject and establish the size and color of the areola together. When, instead, mastectomy is unilateral, the reference point is the existing areola and you will have to reproduce color and size, trying to obtain a faithful copy, to recreate a certain three-dimensionality and to correct a possible asymmetry.

It is necessary to study the basic parameters such as:
- shape
- coloring
- study edges
- veins and tubercles
- dimensions

The final work will be carried out in several sessions (3-4 sessions), to avoid exaggerated irritation and to achieve the perfect tone of color, adjusting it from time to time.


Cases

TREATMENT WITH EXISTING AREOLA (UNILATERAL MASTECTOMY)
Assess the color of the existing areola to obtain a realistic polychromatic result; evaluating the pigment directly on the existing areola.

TREATMENT WITHOUT EXISTING AREOLA (BILATERAL MASTECTOMY)

In cases where the subject has undergone a bilateral mastectomy, there is no natural reference point. In these situations, it is possible to "customize" the type of treatment and not necessarily faithfully reproduce the appearance of before. This applies especially to the size and color, being able to make some changes depending on the considerations of the subject.
When the nipples have been surgically reconstructed, their placement is not always optimal. Often they are very different from each other and it is important to recreate a certain "optical" symmetry and harmony with the whole.

Touch-ups

The areola retouches should be done approximately 5-6 weeks after the previous treatment. It is essential to carefully evaluate the amount of pigment retained by the skin because tissue transplanted with scar outcomes react differently from natural ones and tend or retain too much color (which is why it is not advisable to use too dark colors at the first treatment), or almost completely reject the pigment. In this case the area to be treated will be more receptive during retouching and the skin will retain more color due to cell renewal.
Start retouching first on areas that have lost the pigment and then complete the treatment on the rest of the areola. If it is necessary, also highlight the tubercles.

CASES OF PARTIAL INTERVENTION

When there is a need to reconstruct only part of the areola, both in cases where periareolar scars are present, and when the subject has not undergone any kind of intervention, but wants to improve and/or modify the appearance of its areoles, such as:

 

- Balancing asymmetric areoles
- Recreate the contour of irregular areolas
- Enlarge areolas too small
- Darken areoles too pale

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