Nipple and Areola Surgery
Plastic surgery on the nipple and areola – the pigmented tissue around the nipple – may be performed as separate, isolated procedures on the breast, or concurrently at the time of breast augmentation, breast lift, or breast reduction surgery.
Plastic Surgery of the Nipple
The two most common aesthetic plastic surgery procedures on the nipple are:
- Inverted nipple correction
- Nipple reduction
- Accessory nipple removal
Inverted Nipple Correction
Inverted nipples may occur on one or both breasts, and are the result of shortening or tightening of the ducts that run within the nipple. The condition can be classified according to severity, from mild cases in which there is minimal inversion and the nipples are still capable of becoming erect in response to stimulation, to severe cases where the nipples remain retracted despite stimuli such as touch or cold.
Plastic surgery to correct inverted nipples involves a small incision across the base of the nipple, releasing the duct contraction, and suturing the nipples in a normal, everted or erect position. When done concurrently with other breast procedures, there is no significant additional down time or recovery necessary. If done independently, inverted nipple correction can be carried out under local anaesthesia alone or using only minimal sedation.
Nipples may become enlarged, or hypertrophic, and assume a droopy, floppy, hanging appearance. The condition occurs either in conjunction with or separately from breast enlargement, and may also be seen in patients with very small breasts who wish to undergo breast augmentation surgery. Hypertrophic nipples may be present on one or both breasts, and exhibit different degrees of enlargement.
Plastic surgery to correct enlarged nipples involves measuring the desired new height of the nipple, placing a small incision at the appropriate level to excise the excess tissue, and using sutures to recreate a normal nipple contour. Recovery is short and there is no significant additional down time or recovery necessary when nipple reduction is performed concurrently with other breast procedures, such as breast reduction, breast lift, or breast augmentation. If done as a separate procedure, nipple reduction surgery can be carried out under local anaesthesia alone or using only minimal sedation.
Accessory Nipple Removal
In some women and men, extra nipples and areolas may appear in addition to the main right and left breasts and nipple-areola complex. These accessory tissues may present as isolated nipples, with or without areolas, and occasionally with additional breast tissue underlying the pigmented skin. These accessory nipples often lie as 1-4 lesions along the mammalian milk line, from up just in front of the underarms and inferiorly diagonally across the chest and upper abdomen. Depending on the size and associated tissues, they may respond to hormonal stimuli similarly to normal breast tissue.
Removal of accessory breast tissue involves an incision to include the pigmented nipple and areola, as well as any underlying breast tissue. The procedure is usually performed under local anaesthesia alone, and results in permanent removal of the excess tissues. Recovery is rapid and discomfort is minimal. Patients are usually extremely satisfied with the results and most derive both physical and emotional benefits from accessory nipple removal surgery.
Plastic Surgery of the Areola
In some women, the areolae may occasionally be enlarged or misshapen. This may be a normal congenital variant, or result from overall breast enlargement or pregnancy, or as a results of prior breast surgery. Either one or both areaolae may be affected, and plastic surgery to improve the appearance of the areola may be performed on either one or both breasts.
Areola reduction is possible during concurrent breast enhancement procedures, such as breast lift, breast augmentation, and breast reduction surgery. In these cases, it may be performed using the incisions necessary for the breast enhancement procedure. Plastic surgery on the areola may also be performed uniquely as a separate procedure, in which case it most often requires a periareolar or circumareolar incision, circumferentially around the scar, producing a circular scar around the periphery. When performed on its own without additional breast enhancement procedures, areola reduction only requires local anaesthesia, although sedation may be administered for patient comfort. Results are immediate and recovery usually requires minimal downtime.
Dr. Hutchinson often performs nipple correction surgery and aesthetic areola surgery either alone or in conjunction with aesthetic breast surgery. She will discuss the various options available for nipple and areola surgery and determine which surgical plan offers the best possible results for you.