As the crowns of the breast, the nipple and areola are key components to overall breast aesthetics. Sometimes, nipples do not have their natural projection and appear overly large, droopy, small, flat or turned inward (inverted nipples). What may seem to be an aesthetic issue can create difficulties with breastfeeding as well as with erogenous sensation and become a source of embarrassment for many women. Fortunately correction of these problems can almost always be performed in our office, using just local anesthesia and with minimal recovery.
There are many ways to correct inverted nipples and it’s important to achieve not only a natural appearing nipple-areolar complex but also one that matches the other side as closely as possible. In most cases, the tight ducts are released via extremely small incisions located at the base of the nipple. Unlike some procedures that require more extensive cutting, we prefer a technique where the milk ducts and nerves are preserved to the extent possible and absorbable sutures are used to protect the correction. The procedure is performed under local anesthesia and it takes less than 30 minutes.
Large and elongated nipples can be a source of embarrassment and concern for many women particularly when wearing certain brassieres and clothing. There are many different options available for correction, depending upon the exact nature of the problem. Correction can usually be performed in-office with just local anesthesia. In most cases the incisions are small and well-hidden and every effort is made to retain sensation and the ability to breastfeed.
Nipple and Areola Reconstruction after Breast Cancer
Nipple Surgery FAQ'S
What is the cause of inverted nipples?
In most cases inverted nipples are congenital and result from a shortening of the breast ducts, however, injury, breastfeeding or diseases of the breast, including cancer, can also cause this deformity. If one of both nipples becomes newly inverted you should promptly see a breast specialist to rule out any serious conditions.
How are inverted nipples corrected?
At The Aesthetic Center we use a minimally invasive approach with two very small incisions at the base of the nipple that are used to release the tether. Sometimes, additional tissue is added to enhance projection and guard against recurrence. While some surgeons still cut the milk ducts this can be unnecessarily destructive. A newer technique is available that stretches the fibers and the correction is protected with dissolving sutures.
How is nipple reconstruction performed?
In the flap approach to nipple reconstruction, the nipple projection is created from flaps of adjacent skin and fat. Alternatively a small portion of nipple from the other breast can be transplanted in a procedure known as “nipple sharing.” Both techniques can be performed under local anesthesia as an office-based, outpatient procedure.
How is the areola reconstructed?
Dr. O’Connell prefers to utilize medical tattooing with micropigmentation to simulate the shape, color and texture of the areola. Micropigmentation tattooing is a simple outpatient office procedure performed with local anesthesia in less than one hour.