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The nipple-areola complex is the highlight of an aesthetic breast mound. In youth, the nipple-areola complex lies on the apex of the breast mound, and the nipple adds further projection to this mound. An aesthetic nipple-areola complex lies at the intersection between the vertical midline of the collar bone (clavicle), and a horizontal line above the inframammary fold.
An aesthetic nipple is one that is in the correct position, of appropriate size and projection. It adds a final touch to the aesthetic of the breast mound.
There are normative measurements for the average areola and nipple diameter and projection in females and males. There is also individual variance on what is considered aesthetic and what is regarded as proportional to a person’s height and breast size. Nipples may be excessively enlarged and/or elongated. This may cause reduced self-confidence and social embarrassment with certain styles of clothing or swimwear and withdrawal from certain social or athletic activities.
Nipples may enlarge and elongate due to hormonal changes arising from pregnancy and breastfeeding or male breast enlargement (gynecomastia).
Nipple reduction surgery reduces the nipple diameter and/or projection and restores proportionality and the breast or chest aesthetic. It is a simple procedure that restores body image, self-confidence and improves social functioning. Nipple reduction surgery is performed as an outpatient procedure under local anesthesia with optional intravenous sedation, if requested.
Individuals with abnormal nipple discharge may require screening for breast cancer prior to surgery.
The nipple diameter and/or projection (length) will be reduced to an appropriate diameter and projection so that it is proportionate with the underlying breast mound (in females), or with normative population measurements (in males). The scars are normally well-concealed and inconspicuous when healed.
There are many possible techniques for nipple reduction. The technique chosen is dependent on the severity, the desired final nipple size and the individual’s expectations. Local anesthesia is infused beneath the areola and nipple and the nipple reduction is performed. Proprietary techniques are used for wound closure to minimize scarring to produce an optimal postoperative appearance.
Many individuals are able to return to normal activities immediately following surgery. Minor bruising and swelling is expected, and will mostly resolve by the 5th postoperative day. Mild disturbances to the nipple sensation may occur but are temporary.
Showering is possible from the 2nd postoperative day onwards. Stitch removal is performed on the 10th postoperative day.
