What is Nipple Reduction?
Having overly large, long or drooping nipples may cause embarrassment and discomfort for many patients. They may avoid wearing light clothing such as bathing suits, sheer dresses and sports attire. Women sometimes find it necessary to wear adhesives or padded bras to hide the prominent appearance. They may also have physical problems such as chafing or ulceration.
An overly large, long or droopy nipple may also detract from the appearance of the breast. Techniques developed in the last few years preserve the central core of the nipple, maintaining the nipple’s ability to support breast-feeding while preserving sensation. A nipple reduction procedure is often combined with a breast lift, breast reduction, breast augmentation, or gynecomastia (male breast reduction) surgery. Nipple reduction is also relatively simple to perform by itself under local anesthesia in the office.
Am I a good candidate for nipple reduction?
Good candidates in Boston and Worcester, Massachusetts are uncomfortable with the size or shape of their nipples and are in general good health. It is also important to have a good understanding and realistic expectations of the procedure.
Nipple Reduction – Patient 133
A woman in her early 30’s who is bothered by prominence of her nipples in and out of clothing. She does not have irritation. She also has some mild retraction of the nipple ducts. Her nipple papules are wide and the breast is cone shaped, making it difficult to perform a top hat flap. The top hat flap would not reduce the nipple papule diameter enough, and because the nipple is sitting on top of the cone of her breast, would not reduce the prominence enough. She elected for a nipple amputation technique and is shown 6 weeks after surgery. She is thrilled to have a correction of the prominence. The continued mild nipple retraction which is due to shortening of the nipple ducts is not bothering her at this time.
Nipple Reduction – Patient 132
A man in his later 50’s who has been bothered for years by prominence of his nipples which is visible through his clothing.
He is shown before and again, 6 weeks after bilateral nipple papule reduction with an amputation technique leaving a 3-4 mm base. He is thrilled with his improvement and tells me he wishes he had done this years ago.
Nipple Reduction – Patient 131
An Asian woman in her mid 30’s with bilateral nipple hypertrophy is shown before and again, 2 ½ years after top hat flap reduction of the right and 6 weeks after a second top hat flap reduction on the left. Her initial correction was good but her left nipple papule had increased in size some following her initial procedure and the second reduction was performed.
Nipple Reduction – Patient 130
A man in his early 30’s who had gynecomastia surgery 10 years somewhere else before but is still bothered by prominence of his nipple papules in clothing. He works in the travel industry and is lucky to be able to spend a lot of time at the beach and in summer clothes. His left nipple bothers him more than the right nipple. The left nipple papule is 6 mm in diameter and 7 mm high. His right nipple papule is 5 mm in diameter and 5 mm high. After discussions we decided to proceed with bilateral nipple papule reduction utilizing the nipple amputation technique under local anesthesia in the office. He is shown before and again, 6 weeks after correction.
Discussion: He appears that he may still have mild gynecomastia but this is not present with the “hands on the head” view and may be due to mild skin laxity but not additional tissue thickness which means that further surgery of the chest would not be helpful. His nipples do appear prominent. “Normal” measurements for the nipple papule have not been reported but in a female are generally considered to be 8 by 8 mm. My experience in males is that they prefer a flatter nipple to prevent prominence in clothing. Our patient is thrilled with the normal appearance of his nipples and no longer has prominence of the nipples visible in a thin shirt.
Nipple Reduction – Patient 129
A woman in her mid 30’s who is bothered by prominence of her nipples. She wanted them to be smaller and less prominent in clothing but still natural in appearance. There is no standard measurement for a hypertrophic nipple but a “normal” nipple is sometimes suggested to be 1 cm wide by 1 cm in projection and in a women I typically aim for a correction to reduce the nipple to 8 mm wide by 8 mm high, as we have done here. Our patient is shown before and again, 6 weeks after a “top hat flap” nipple papule reduction performed under local anesthesia in the office. Her nipple sensation remains intact and she is thrilled with the correction.
How is nipple reduction performed?
Nipple reduction surgery is done under local anesthesia and usually takes around an hour to complete. Dr. Hall creates a small incision in the nipple, and removes any excess tissue from the area. Stitches are then placed to close the incision, and dressings are applied to the breasts. A special surgical bra will need to be word to ensure optimal healing. Results from nipple reduction surgery are permanent, though the natural aging process may contribute to dropping or sagging of the breasts.
What should I expect during recovery?
Nipple reduction surgery is an outpatient procedure, so patients generally return home after their reduction. It is important to note that some patients have someone drive them home, as they will not be able to drive themselves. Pain medication can be prescribed to control any pain or soreness you may experience. Patients should wait one to two days after surgery to drive, bathe, and resume working. It is also advised that patients avoid strenuous activity for three weeks post-op. It is advised that patients sleep on their back only for the first week, as to ensure ideal healing.
As with any invasive surgery, scars will be present. It often takes several months to a year for scars to fade. Bruising often disappears after two weeks, and stitches can be removed within a week of surgery. Sometimes, patients may experience slight numbness or tingling in the nipple area, though this will go away within six weeks.
A consultation is the first step towards a more confident you. If you are interested in nipple reduction surgery in Boston, MA, contact Dr. Hall today at 781-473-0277 to schedule your initial consultation.
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