Wondering what a nipple delay is? I was too! I hadn’t heard of this procedure until Angelina Jolie announced to the world that she underwent a prophylactic double mastectomy and this procedure was part of the process.
Since that announcement, many different articles and opinions have been published. A lot of them positive, but a few negative. That’s another post for another day. A few pieces did provide more information on the nipple delay procedure.
What is nipple delay?
During the nipple delay procedure, the surgeon makes an incision in the skin and severs the breast tissue and blood vessels directly beneath the nipple (it remains attached to the surrounding skin). Due to this, the nipple is no longer dependent upon the blood supply directly beneath it and becomes accustomed to getting its blood supply through the skin. According to the Pink Lotus Breast Center blog, it actually recruits additional blood flow not previously established.
This is an uncommon procedure. If it is elected, it is performed some time before the mastectomy; two weeks for Angelina Jolie.
Why have a nipple delay?
Surgical nipple delay is used to decrease likelihood of nipple necrosis, which can occur because of loss of blood supply and can lead to nipple loss, following a nipple-sparing mastectomy.
Breast skin is fragile after mastectomy. If it’s exceptionally thin after the breast tissue is cut away or is handled too roughly, it may die. The same result may occur if the breast surgeon severs too many blood vessels that feed the skin or uses eletrocautery too aggressively and burns the inside of the skin, which may then blister and die.
– Steligo, Kathy. Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery. Maryland: The Johns Hopkins University Press, 2012. Print, third edition.
I was not informed of this option prior to my own nipple-sparing mastectomy. My compromised blood flow resulted in necrosis on my left breast and I lost a nipple. If you are interested in reading about my bout with necrosis (including photos) and the hyperbaric treatment I underwent in an effort to thwart it, please read Tissue necrosis.
Related articles:
- Surgical Delay of the Nipple–Areolar Complex: A Powerful Technique to Maximize Nipple Viability Following Nipple-Sparing Mastectomy (annsurgoncol.org)
- Angelina Jolie’s ‘nipple delay’ procedure, explained (NYmag.com)
- A patient’s journey: Angelina Jolie (PinkLotusBreastCenter.com)
Source of Figure 1.1: Steligo, Kathy. Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery. Maryland: The Johns Hopkins University Press, 2012. Print, third edition.
Saying NOPE to Breast Cancer 
I had a delay procedure on my abdomen to increase upper blood flow in my TRAM flap. This is usually done to reduce TRAM complications in obese women. My surgeon does it for all TRAMs. I hadn.t heard of nipple delay either. I lost part of my nipple due to necrosis. It looks like the eraser end of a pencil after correcting lots of mistakes!
This is very interesting. I had no idea that surgical delay was even an option, whether nipple or flap! So we’re part of the one-nipple-people club, huh?
I’ve got a nipple and a fourth I think. But I would love to be in a club with you, nonetheless.
Sound like this procedure needs to be used for everyone… Once again one continues to learn…
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It’s so great that everyone can get an idea of other ways to “skin a cat” 🙂
I had nipples “made” on my hips when the first part of the TRAM was done (the fat tissue moved into the breast area along with blood vessels) He folded some tissue over at the two ends of the incision along my pubic area and left them hanging. Then he harvested them and made nipples for me and attached them when he did the implants.
This is brilliant. I told people at the pub what this meant the other day. I sounded very knowledgeable. Thanks Mogatos! x
Haha. Great topic to discuss at a pub over a couple of pints! 🙂
I’m preparing for my nipple delay. I’m really pleased that my surgeons decided I would be an excellent candidate. Hoping it goes well… I’ll keep you posted!
Great! When is the procedure scheduled for? I would love to get an update.
Love the post. Actually am also preparing for my nipple delay and after read all your comments on this blog feel bit good.