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FAQ: Nipple Procedures

Inverted Nipple Repair

Problem: The nipple looks flat or appears as a slit-like depression.
Cause: Fibrous strands that prevent the nipple from projecting.
Surgery: A small incision in the nipple releases the tethering bands. If necessary, an internal suture around the base of the nipple prevents the nipple from “falling back in.”
Detail: Many women undergoing breast enlargement will note improvement of inverted nipples. The pressure of the implant may “push out” an inverted nipple.

Nipple Reduction

Problem: The nipple is too large or “sticks out” too much. It may be difficult to conceal in clothing. Cause: May be genetic or related to childbirth and breastfeeding.
Surgery: A wedge of excessive nipple is removed, repairing the edges and leaving the remaining nipple tissues intact.
Detail: This procedure will not reduce nipple sensation but frequently compromises breastfeeding.

Nipple Lift

Problem: The nipple sags or droops. It may also be enlarged.
Cause: Commonly related to breastfeeding and subsequent loss of breast volume.
Surgery: An enlarged nipple may be reduced, improving the sagging. Alternatively, a small crescent of pigmented areolar skin may be removed just above the nipple, lifting the sagging nipple.
Detail: Breast enlargement frequently improves drooping nipples. The pressure of the implant may “push up” a sagging nipple.

Nipple Reconstruction

Problem: The nipple is absent.
Cause: Usually due to mastectomy for breast cancer.
Surgery: Local tissues are rearranged to create a new nipple.
Detail: The reconstructed nipple-areola is subsequently pigmented via medical tattooing.

Areolar Reduction (Periareolar or Donut Mastopexy)

Problem: The areola (pigmented tissue surrounding the nipple) is enlarged.
Cause: May be genetic or related to stretching from childbirth and breastfeeding.
Surgery: The outer portion of the areola is removed. A permanent pursestring (drawstring) suture is placed to cinch down the diameter, reducing the areola size.
Detail: The procedure is generally done in conjunction with breast enlargement and lifting. It is also a standard part of most breast lifts and reductions.

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© 2018 Ronald M. Friedman, M.D., P.A.

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