Nipple Procedures

Are you concerned with the size, shape, or placement of your nipples? Dr. Koenig and Dr. Amalfi offer procedures to address both large nipples or those that are inverted. These can be done either in the office or combined with breast or body surgery, offering personalized options our patients from Rochester, Syracuse, and Buffalo, New York, and surrounding areas.


Nipple Procedures

Nipple Reduction

Some women are self-conscious about their nipples when they are too prominent. It can be impossible to go without a bra and some women will experience irritation and chaffing of their nipples even when wearing a bra. The reduction of very prominent nipples can be performed while retaining sensation with a simple office procedure at the Lindsay House and performed under local anesthesia. The results are very predictable and the scars are virtually undetectable.

Nipple Procedures
 Before & After Photos


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Areola Reduction

Some patients desire a reduction of the areola when it is prominent and covers a large area of the breast. This can be done as part of a mastopexy (breast lift) operation or a breast reduction. Scars generally heal well but are slightly detectable around the circumference of the nipple.

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Inverted Nipple Repair

Inverted nipples are a lot more common than people realize. Approximately 10-20% of women, and many men, have inverted or flat nipples. Inverted nipples go inward, or lay flat against the chest, instead of protruding outwards.

An inverted nipple is caused by tissue in the breast that is attached tightly to the inside of the nipple skin. This 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 outwards, causing the inversion.

Nipples can be inverted from birth or invert later in life. Nipple inversion is often times genetic and exists at birth or happens during puberty as the breasts develop. If it’s not genetic, inversion can happen due to constricted milk ducts, scarring of the milk ducts due to breastfeeding, or a lack of skin at the base of the nipple.

Quatela Center for Plastic Surgery surgeons Dr. Koenig, Dr. Amalfi
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Choosing the Right Plastic Surgeon
William J. Koenig, M.D.
Specializes in Breast & Body Procedures
William J. Koenig, M.D.

Dr. William J. Koenig is a double board-certified plastic surgeon with over 26 years of experience. He specializes in breast and body procedures and has performed over 6,000 breast augmentations throughout his years of practice.

Ashley N. Amalfi, M.D.
Specializes in Breast & Body Procedures
Ashley N. Amalfi, M.D.

Dr. Ashley N. Amalfi is a board-certified plastic surgeon who specializes in cosmetic surgery of the breast and body. With her experience and innate attention to detail, Dr. Amalfi achieves personalized surgical outcomes that help patients look and feel their best.

It is important to note that if you have never had inverted nipples before and they change, this can be a cause for concern and should be mentioned to your doctor. Unfortunately, new nipple inversion can indicate breast cancer so it is best to speak to your healthcare provider to ensure that is not the case.

In order to correct inverted nipples, a minor procedure is usually necessary. This is done in the office under local anesthesia and takes less than an hour. Two stitches are placed underneath the nipple to create a pad for it to sit on and remain outward.

A local anesthetic is used during inverted nipple correction and there may be slight discomfort when that wears off. However, discomfort usually does not last longer than a week. Patients are able to return to work after the procedure but are asked to avoid exercise and strenuous activity that would cause rubbing against the nipple area for about a week.

Since the milk ducts are divided or lengthened during the inverted nipple procedure, breastfeeding will not be possible afterwards. This is something that you need to consider prior to the procedure and perhaps decide to have your nipples corrected after breastfeeding is complete.

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How Much is Nipple Reduction Surgery?

The cost of nipple procedures, including inverted nipple repair, varies depending on your specific needs and goals. All prices quoted from the Quatela Center are all-inclusive and include pre- and post-operative appointments, surgeon’s fees, surgery center fees (if applicable), and anesthesia costs. For more information, see our page on Plastic Surgery Costs.

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The Quatela Center for Plastic Surgery in Rochester is proud to serve patients from throughout Upstate NY. We are honored to be the area’s premier plastic surgery center, and give every patient our undivided attention and the quality of care they deserve. Learn more about how we support our New York patients on their surgical journeys: