renbird - have you spoken to a plastic surgeon yet? I think it will be important to find a surgeon who not only has a lot of NS experience, but who has also done this specific surgery - more than once. I had a nipple sparing with reconstruction, but my concern would be nipple placement and symmetry if you do this without recon. Are you considering bi-lateral surgery? Success would partly depend on technique and your current size. My surgeon placed the incisions for mastectomy in the IMF, under the breast, so that when the expander was placed it occupied the space the breast tissue had and left the area of the nipple with no incisions, and the nipples were where they had always been. Without any volume underneath the nipple they might not be located in the logical spot, unless you are extremely small breasted. You may also find that they don't look symmetrical if there are any anatomical issues that make the sides of your chest unlike each other. Some surgeons who do nipple sparing actually relocate the nipples and graft them afterward, which would allow for a choice in placement, but mean a more extensive surgical experience. I am not advocating for reconstruction for you, as I think all choices about that are very individual and should be respected, I am just concerned that you end up with what you are envisioning. I believe that there have been a few people who have done a nipple sparing with no recon, try putting that combination of words in the search function and you may be able to PM someone who has done it and ask them about it. Wishing you the best!

beesie - we were synced up!

renbird - you are asking smart questions. One thing to consider is maybe not sparing the nipple and doing a 3D tattoo later? That way you can chose the placement, and since the spared nipple amounts to a skin decoration, a tattoo basically does the same thing with more control. I ended up with some issues and after many surgeries - involving necrotic skin, but not the nipples - I ended up with an asymmetric nipple situation. It bothered me a lot, and I ultimately removed both. I will say that my initial skin and nipple sparing BMX result was amazing and it was just unfortunate circumstances that led to the successive surgeries. I wonder if your surgeon can use the existing incision for the mastectomy and an areola incision if the nipple is removed which could later be covered by tattoo. There is also something called a purse string incision that uses the areola incision for the mastectomy itself, but I don’t know if it can be used in your circumstance. Some things to consider.

I wore a prosthesis initially for seven months, then again for 18 months, with a spared nipple on my temporarily flat side and did not have any issues. I suppose it might be possible to have some chafing but I’m not sure it would be uncomfortable, rather not optimal for the skin.