Certain conditions may cause both men and women to feel self-conscious about the appearance of their nipples and surrounding pigmented skin - the areolae. From cosmetic concerns about the shape and size of the nipples or areola, to functional problems like inverted nipples that affect breastfeeding, most issues can be corrected with surgery or injections of dermal fillers.
- Before & Aftercare
- Pros & Cons
- Side Effects
- List of Sources
Nipple surgery includes several types of differing breast procedures. Some patients seek a reduction in the size of the areolae, which are the pigmented areas of skin that encircle the nipples. According to the American Society of Plastic Surgeons, other cosmetic procedures involve making each areola more symmetrical.
Additional plastic surgery procedures for the nipples include nipple reduction surgery to correct abnormally elongated or large nipples. Other conditions corrected by areola or nipple surgery are congenital ones, such as individuals who have inverted nipples or misshapen nipples that often accompany tubular breasts where breast tissue is narrowed. Lastly, more prominent nipples can be created via dermal filler injections to treat nipple inversion cases.
Areola Reduction People who are dissatisfied with the size or shape of their areolae can choose to have them reduced via plastic surgery. Some individuals are born with mismatched areolae or ones too big for their liking. However, some men and women notice that weight gain, weight loss, pregnancy, or breastfeeding alters the areolae size and shape. Surgical procedures to remove excess pigmented skin can enhance the shape and size of the areolae.
Nipple Augmentation In the same way that injections of hyaluronic acid fillers add volume to the lips or other areas, nipple injections can help to increase the projection of the nipples. It is a solution employed to correct cases of nipple inversion, wherein the nipple retracts inward instead of outward. The cosmetic procedure is often performed in the wake of breast reconstruction surgery, or for patients to who wish to have continually erect nipples with more projection.
Nipple Reduction for Enlarged Nipples Nipple reduction surgery for large nipples involves removing excess parts of the nipple that may represent deformities or an undesirable appearance. According to Beverly Hills board-certified plastic surgeon Dr. Stuart A. Linder, the breast development condition known as nipple hypertrophy happens when milk ducts and their connected nipples develop in an enlarged manner. The condition can impact both men and women. Nipple reduction surgery also corrects conditions whereby the nipples are elongated or point downwards and sag as a result of breastfeeding. The procedure features little downtime and a short recovery period when performed as a single surgery under local anesthesia. It can be combined with additional breast surgery procedures such as a breast lift, breast augmentation, or breast reduction surgery.
Inverted Nipple Correction Surgery Inverted nipples are ones that retract inward, and may cause psychological concerns for the patient who feels embarrassed by the condition. From mild to severe cases, nipple inversion can be caused by short or scarred milk ducts - and in rare cases, as a result of cancer.
According to the American Society of Plastic Surgeons, nipple correction surgery may involve cutting the milk ducts, which could negatively impact the potential for breastfeeding. The procedure is performed using IV sedation or local anesthesia. Dr. Karen Horton explains that the surgery creates tiny incisions at the base of the nipple, and plastic surgeons make every attempt to preserve function of the milk ducts.
Surgical Correction of Extra Nipples Select men and women have excess breast tissue, areolas, or nipples that appear along the milk lines that run in the shape of a V from the armpits down to the abdomen. For their own sense of well-being, individuals seek to have the circular pigmented skin areas removed, particularly when the extra nipples secrete milk. Surgical procedures can permanently remove any excess breast tissue, extra nipples, and areolas.
Ideal Candidates for Nipple Surgery
According to Brigham and Women's Hospital, many surgical procedures for the nipple take less than one hour, and might be ideal for the following candidates:
- Healthy patients who are troubled by the appearance of the nipples or areola
- People with nipples that sag below the breast crease
- Individuals with downward-pointing nipples, areolas, and stretched skin
Plastic Surgery & Dermatology of NYC adds that good candidates for inverted nipple correction include individuals with depressed or flat nipples.
Nipple Surgery Contraindications
Nipple correction surgery may not be the correct solution for everyone. Drs. Elie and Jody A. Levine advise anyone who experiences sudden nipple inversion to meet with a breast specialist prior to seeking inverted nipple correction surgery in order to determine if underlying medical conditions could be the cause.
Candidates who are not ideal patients for nipple surgery include the following:
- Smokers who are unwilling to quit prior to and after surgery due to smoking's impact on skin healing
- Those who have not maintained a stable, healthy weight
- Patients who have unrealistic expectations about surgery
Cost of Nipple Surgery
The cost of nipple and areola surgery can vary widely, based upon the specific surgical procedure being performed. According to The Plastic Surgery Clinic, inverted nipple correction will likely not be covered by insurance companies that view it and similar procedures as forms of cosmetic surgery. However, contact your insurance company to determine if you are a candidate for coverage, especially when illnesses, injuries, or other congenital medical conditions have caused the problem.
During your initial consultation with your plastic surgeon, discuss financing plans available for your cosmetic surgery. Since nipple and areola surgeries vary based on the patient - and are sometimes combined with other procedures - the expenses can run the gamut. For example, a breast lift is commonly performed in conjunction with a nipple correction procedure, which would have an additional average cost of $4,672. However, combining multiple surgeries can sometimes reduce the overall price of each procedure. Be sure to talk with your provider about every procedure you are interested in having performed.
The Parker Center for Plastic Surgery places inverted nipple surgery costs anywhere from $1,000 up to $2,500 for bilateral nipple surgery. Financing through healthcare financial firms such as CareCredit or via extended payment plans can help patients pay for the procedures.
Recovery From Nipple Surgery
Recovery from nipple surgery is also dependent upon the complexity and range of the surgical procedure. Standalone nipple surgery often comes with little downtime and short recovery periods.
Patients generally receive a sedative and local anesthetic prior to surgery for optimal comfort, according to the Long Island Plastic Surgical Group in New York. Inverted nipple surgery recovery may involve swelling and mild discomfort that can be addressed with pain medication.
Approximately four days after inverted nipple surgery, sutures are usually removed and patients can return to their normal routines, although they should take care to avoid strenuous activities for several weeks.
Before and Aftercare of Nipple Surgery
Prior to seeking plastic surgery to correct nipple concerns, research board-certified plastic surgeons who have in-depth experience and knowledge in the field. Particularly for those women who still desire to breastfeed after nipple surgery, Cleveland Clinic advises that patients understand the effect that any type of breast surgery can have upon lactating.
Surgeries such as breast augmentations, breast lifts, nipple surgery, and areola surgery may cause a reduction in the amount of milk that is produced. Therefore, ensure that the surgeon understands any desire to breastfeed in the wake of the surgery, in order to accordingly allow the nipple and areola to remain attached to the milk ducts and breasts as much as possible during surgery for a successful outcome.
The Pros & Cons of Nipple Surgery
The benefits of surgical procedures to correct problems with the nipples and areola can be manifold:
- Improved intimate relationships due to patients no longer being self-conscious of their breast area
- Increased self-esteem and confidence
- The potential to experience successful breastfeeding after surgical correction of inverted nipples
The cons of nipple surgery may include the following:
- The risk of loss of nipple sensation if the nerves and blood vessel supply is severed
- The possibility of inability to breastfeed if milk ducts are cut
- Scars around the areolas
According to the Breast Health & Healing Foundation, when nipple surgery is performed by a knowledgeable plastic surgeon, it can be a positive venture. But similar to all surgeries, nipple surgery is accompanied by certain risks, including the following:
- Nipples that invert again after surgery
- A loss of breast sensation on a temporary basis
- The loss of the ability to breastfeed on a permanent basis
Conclusion: Weigh Your Risks Versus Rewards with Nipple Surgery
Nipple surgery can be a positive experience for patients who may have felt a lifetime of embarrassment due to the appearance of their chest. Discovering a well-qualified, board-certified plastic surgeon who understands your needs is the first step in the journey. It is essential to weigh the desire for a corrective or enhancement surgery against any risks that may accompany the procedure - such as the potential for a permanent loss of breastfeeding. Patients can correct inverted or large nipples and reduce the size or correct asymmetry of the areolae during a quick, outpatient procedure. Consult with your plastic surgeon to see if you are an eligible patient for treatment.
List of Sources
- U.S. National Library of Medicine's National Institutes of Health: Treatment of nipple hypertrophy by a simplified reduction technique
- American Society of Plastic Surgeons: Cosmetic procedures for the nipples and areolas
- Brigham and Women's Hospital: Nipple Areola Correction
- Nipple Surgery San Francisco Bay Area CA - Dr. Karen Horton
- Long Island Plastic Surgery Group: Inverted Nipple Surgery
- Plastic Surgery & Dermatology of NYC
- 2017 Cosmetic Plastic Surgery Statistics
- American Society of Plastic Surgeons 2017 Average Surgeon/Physician Fees
- The Plastic Surgery Clinic
- Parker Center for Plastic Surgery
- American Society of Plastic Surgeons: Mommy makeover – how much does it cost?
- Dr. Linder's Blog: Nipple Hypertrophy Correction
- Breast Health & Healing Foundation: Dealing with Inverted Nipples