Chapter 27: Living with and beyond cancer
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Related theory
The reconstruction process
Areolar tattooing is the final part of a long process facing a woman after breast cancer diagnosis and treatment. If immediate reconstruction with expanders is chosen, patients undergo weekly saline injections until the desired overfill amount is achieved. Then they wait approximately 2 months for the skin to stretch adequately to ensure there is enough to cover an implant (Rolph et al. [240]).
The patient then goes back to the operating theatre for implant placement and waits 6 weeks to have nipple flap reconstruction. The nipple flap is not done at the time of implant placement because the patient is placed in a compression bra post surgery to prevent seroma formation. The compression on the nipple flap could compromise the blood flow to the flap, which might diminish its viability.
If patients choose immediate or delayed flap reconstruction, they must wait 6 weeks to 2 months post surgery to be taken back to the operating theatre for revision of the flap and nipple flap reconstruction.
In either scenario, the patient must then wait from 6 weeks to 3 months, based on her surgeon's preference, to have the areolar tattoo done. These time periods are dependent on whether the patient requires adjuvant therapy for her cancer (Sisti et al. [258]).
