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Category: Nipple Procedures

Improving Nipple Projection: Surgery for Inverted Nipples and Flat Nipples

Inverted nipples are surprisingly common, occurring in 3 – 5% of women. Instead of the nipple “pointing out,” it retracts inward, usually due to tethering bands of fibrous tissue. Most women with inverted nipples have a normal amount of nipple skin; it’s just pointing the wrong direction.

Inverted nipple repair
inverted nipple front before inverted nipple front after
Before After

 

Flat nipples are also quite common. This entails a lack of nipple projection due to a lack of nipple skin. Flat nipples are not tethered; they just remain flat despite heat, cold, and stimulation.

Flat nipple repair
flat nipple side before flat nipple side after
Before After

 

Surgical treatment of both inverted nipples and flat nipples is essentially the same. Over the last 20 years, my technique has evolved to utilize very small incisions for these repairs.

 

Surgical sequence (about 30 minutes per nipple in the office under local anesthesia):

  1. I mark the outer border of the nipple. In women with flat nipples, this outer border will be widened, in order to recruit adjacent pigmented areolar skin to become nipple skin.
  2. We provide laughing gas (70% nitrous oxide) to help you feel tipsy.
  3. Local anesthetic is injected to the surgical site. After this, you will experience no pain.
  4. Two sutures are placed in the center of the nipple to enable traction.
  5. A small incision (about 3 mm or 1/8th inch) is made adjacent to the nipple.
  6. Fibrous bands are divided to “release” the nipple, enabling improved nipple projection.
  7. An absorbable “purse-string” or drawstring suture is placed around the base of the nipple, further improving projection and preventing recurrent retraction or flattening.
  8. The 3 mm incision is closed with two or three absorbable sutures.
  9. A surgical dressing is applied to protect the repair and to splint the nipple in its new projecting position. The dressing “sticks out” quite a bit, so we usually refer to it as “the Madonna bra.”

 

Postoperative recovery:

  1. You can drive yourself home. The laughing gas wears off in about 10 minutes.
  2. We will remove your Madonna bra dressing and the traction sutures one week after surgery. Your nipple correction should be immediately apparent.
  3. You will treat the 1/8” incision with antibiotic ointment for about another week.
  4. You will need to avoid compression of the nipples for about 6 weeks. This means going without a bra or cutting large holes in the center of an existing bra.

 

Keep in mind that the sole purpose of surgery for flat or inverted nipples is to improve their appearance. Women with these conditions are frequently unable to successfully breastfeed prior to surgery—and will generally be unable to do so after surgery.

 

Ronald M. Friedman, M.D.

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas

www.plasticsurgerydallas.com

Cosmetic and Plastic Surgery in Wylie, Texas

Board-certified plastic surgeon, Ronald M. Friedman, M.D., has provided cosmetic and reconstructive surgery for the Wylie, Texas community since 1996.  Dr. Friedman serves as the Director of the West Plano Plastic Surgery Center, located on the campus of Texas Health Presbyterian Hospital of Plano–just a 15 minute drive from Wylie.  Dr. Friedman is known for his natural results in breast augmentation, breast lift, liposuction, tummy tuck, mommy makeovers, and Botox and Restylane injections.

D Magazine has named Dr. Friedman a Best Plastic Surgeon for FIVE consecutive years.  He was also named a Texas SuperDoctor by Texas Monthly magazine for four consecutive years. While working on the full-time plastic surgery faculty at the University of Texas Southwestern Medical Center in Dallas,  Dr. Friedman served as the Chief of Plastic Surgery at Parkland Memorial.

Dr. Friedman has a unique background as a wood and marble sculptor for over 25 years.  He believes that his artistic background has helped him to become a better plastic surgeon.

For more information about Dr. Friedman, including before and after photos, please visit www.plasticsurgerydallas.com.

Cosmetic and Plastic Surgery in Fairview, Texas

Board-certified plastic surgeon, Ronald M. Friedman, M.D., has provided cosmetic and reconstructive surgery for the Fairview, Texas community since 1996.  Dr. Friedman serves as the Director of the West Plano Plastic Surgery Center, located on the campus of Texas Health Presbyterian Hospital of Plano–just a 15 minute drive from Fairview.  Dr. Friedman is known for his natural results in breast augmentation, breast lift, liposuction, tummy tuck, mommy makeovers, and Botox and Restylane injections.

D Magazine has named Dr. Friedman a Best Plastic Surgeon for five consecutive years.  He was also named a Texas SuperDoctor by Texas Monthly magazine for four consecutive years. While working on the full-time plastic surgery faculty at the University of Texas Southwestern Medical Center in Dallas,  Dr. Friedman served as the Chief of Plastic Surgery at Parkland Memorial.

Dr. Friedman has a unique background as a wood and marble sculptor for over 25 years.  He believes that his artistic background has helped him to become a better plastic surgeon.

For more information about Dr. Friedman, including before and after photos, please visit www.plasticsurgerydallas.com.

Cosmetic Surgery in Van Alstyne, Texas

Board-certified plastic surgeon, Ronald M. Friedman, M.D., has been providing cosmetic and reconstructive surgery to the Van Alstyne, Texas community since 1996.  Dr. Friedman serves as the Director of the West Plano Plastic Surgery Center, located on the campus of Texas Health Presbyterian Hospital of Plano–just a half hour drive from Van Alstyne.  Dr. Friedman is known for his natural results in breast augmentation, breast lift, liposuction, tummy tuck, mommy makeovers, and Botox and Restylane injections.

D Magazine has named Dr. Friedman a Best Plastic Surgeon for five consecutive years.  He was also named a Texas SuperDoctor by Texas Monthly magazine for four consecutive years. While working on the full-time plastic surgery faculty at the University of Texas Southwestern Medical Center in Dallas,  Dr. Friedman served as the Chief of Plastic Surgery at Parkland Memorial.

Dr. Friedman has a unique background as a wood and marble sculptor for over 25 years.  He believes that his artistic background has helped him to become a better plastic surgeon.

For more information about Dr. Friedman, including before and after photos, please visit www.plasticsurgerydallas.com.

 

Cosmetic Surgery in Melissa and Anna, Texas

        

Ronald M. Friedman, M.D., a board-certified plastic surgeon, has been providing cosmetic and reconstructive surgery to the Melissa, Texas  and Anna, Texas communities since 1996.  Dr. Friedman serves as the Director of the West Plano Plastic Surgery Center, located on the campus of Texas Health Presbyterian Hospital of Plano–just a half hour drive from Melissa and Anna.  Known for his natural results, Dr. Friedman specializes in breast augmentation, breast lift, liposuction, tummy tuck, mommy makeovers, and Botox and Restylane injections.

D Magazine has named Dr. Friedman a Best Plastic Surgeon for five consecutive years.  He was also named a Texas SuperDoctor by Texas Monthly magazine for four consecutive years. While working on the full-time plastic surgery faculty at the University of Texas Southwestern Medical Center in Dallas,  Dr. Friedman served as the Chief of Plastic Surgery at Parkland Memorial.

Dr. Friedman has also been a wood and marble sculptor for over 25 years.  He believes that his artistic background has helped him to become a better plastic surgeon.

For more information about Dr. Friedman, including before and after photos, please visit www.plasticsurgerydallas.com.

© 2018 Ronald M. Friedman, M.D., P.A.

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