The growing popularity of nipple and areola surgery

– By double board-certified plastic surgeon Dr. William J. Koenig

Breast implant surgery to enhance the size and shape of the breasts is one of the most popular and well-known cosmetic surgery procedures, but did you know surgery can also be performed to change the size and shape of the nipples and areola (pigmented skin around the nipple)?

Nipple and areola reduction surgery, as well as inverted nipple repair, is increasingly requested, as a growing number of women and men become aware there are treatment options available to them to give them the nipple and areola shape and size they desire.

Often performed in conjunction with breast reduction surgery, nipple and areola reduction can also be standalone procedures and usually performed in the doctor’s office.

Inverted nipples

Did you know that about 10-20% of women, and many men, have inverted or flat nipples, making them more common than blue or green eyes? The issue is rarely talked about, but treatment exists and it’s easier than you may think.

Inverted nipples simply go inward, or lay flat, against the chest instead of protruding outward. This positioning is caused by tissue in the breast that is attached tightly to the inside of the nipple skin, which pulls it inward toward the inside of the chest. The force of tight, shortened milk ducts can be greater than the muscle in the nipple that pulls it outward, causing the inversion.

Nipple inversion can be present from birth or happen later in life. It is often genetic and exists at birth or during puberty as the breasts develop. When not genetic, it can happen due to constricted or scarred milk ducts due to breastfeeding, or a lack of skin at the base of the nipple.

Nipple and areola reduction

On the other hand, some women and men are self-conscious about nipples that are too prominent, which can cause irritation and chaffing. In addition, the size of the areola can be reduced, a procedure that is fast growing in popularity.

Many nipple and areola concerns can be addressed with a simple in-office procedure using a local anesthetic to the area. While slight discomfort may be experienced after the anesthesia wears off, it usually does not last longer than a week. Patients are able to return to work immediately after the procedure, with the only restriction being to avoid exercise and strenuous activity that may cause rubbing against the nipple area for about a week.

Sensation is maintained with the nipple reduction procedure. During an inverted nipple procedure, the milk ducts are divided or lengthened, so breastfeeding is not possible afterward and should be considered prior to the procedure.

So whether your nipples are inverted, protruding, large or small, nipples and areolas can be reshaped to your liking.

For more information on nipple and areola reduction and to see before and after photos, click here.

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