San Diego Cosmetic Surgeon Dr. Tom Pousti Talks About Inverted Nipple Repair, Nipple Reduction and areola reduction.
Areola Reduction, nipple reduction and inverted nipple repair are rarely thought of when patients consider enhancing the breasts. The procedures that are normally thought of are breast enlargements, breast lifting or breast reductions. For some patients, they not only want the breast size taken care of, but also have concerns regarding their nipple and/or areola– the nipple is the projected part and the areola is the dark pigmented skin that surrounds the nipple. Patients are happy to hear it’s a simple procedure to enhance the nipple/areola. Whether the nipple is inverted, too big or protruding too far, Dr. Pousti can assist you with correction.
Inverted nipples can cause functional problems for women and emotional concerns. An inverted nipple can look flat or a slit like depression or hole at the normal nipple location. There are different degrees of inverted nipples possible. Correction of inverted nipples depends on the problem.
Large and/or puffy areolas cause patients to be concerned with their appearance out of clothing.
Large nipples can be bothersome to a woman’s appearance. Whether the nipples are long or have a large circumference, women find it uncomfortable in clothing and in the nude. Sometimes the nipples are large due to genetics or happen after childbirth and/or breast feeding.
Nipple reduction surgery, inverted nipple repair and areola reduction surgery can all be performed in conjunction with other breast procedures such as breast augmentation, breast lifting or breast reduction surgery. These procedures are performed by Dr. Pousti in an outpatient surgery center under general or local anesthesia. When performed alone, these procedures would take less than one hour and the patients can return to their normal activity within a few days.
The Surgical Procedure
The first step in nipple reduction, inverted nipple repair or areola reduction surgery is to be examined by Dr. Pousti either in his San Diego or Temecula/Murrieta office. After the examination, Dr. Pousti will discuss the procedure with you along with your options. These procedures would be performed under local anesthesia unless it is performed in conjunction with another breast procedure such as breast augmentation, breast lifting or breast reduction surgery.
Inverted nipple repair: The objective is to reshape the nipple and areola so that the nipple projects out from the breast, enhancing the appearance of the breast while preserving sensitivity of the nipple. The technique that leaves the milk ducts intact can also help preserve a woman’s ability to breastfeed.
When correction of nipple inversion surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, as with any surgery, there are risks. These include re-inversion, infection, bleeding, skin injury, adverse reaction to anesthesia, noticeable scars, permanent pigment changes, or slightly mismatched nipples. The procedure may also result in noticeable scars, permanent pigment changes in the breast area, or slightly mismatched breasts or nipples. Nipple protrusion with stimulation may change. If nipple inversion recurs or asymmetry is significant, a second procedure may be needed. The temporary effects of inverted nipple surgery include loss of breast sensation or numbness, which may last up to a year.
Areola Reduction repair: Areola reductions begin by removing the pigmented area either from the outside of the areola or from around the base of the nipple. Dr. Pousti minimizes the incisions so that there is minimal scarring. Dissolving sutures are used so that suture removal will not be necessary after the procedure.
Nipple reduction surgery:
Length reduction– Nipples that are too long either droop down or project too far out. Usually, to create a shorter nipple length, the tip of the nipple will be removed and sutured for closure. Sometimes the skin along the neck of the nipple will be removed. In those circumstances, the tip of the nipple is then sutured to the bottom of the nipple, creating a shorted nipple length.
Width reduction– If the nipple is too wide, but not too long, a pie-shaped wedge will be removed from the undersurface of the nipple. This allows the nipple to be “taken in” and the circumference reduced. Dissolving sutures are used.
After the Surgery
You will feel some discomfort for a few days after surgery. However, discomfort can be controlled with medications prescribed by Dr. Pousti. In any case, you should arrange to have someone drive you home after surgery and to help you out for a day or two if needed.
You’ll be swollen and bruised for a few days.
Resumption of Physical Activities It is important to begin getting back to normal. You’ll be encouraged to begin walking around on the day of surgery, and can return to work when you feel well enough–which could be as early as a day or two after surgery. Any stitches will generally be removed about 1 to 2 weeks following the procedure.
Dr. Pousti may advise you to avoid sexual activity for a week or two, and heavy exercise for about three weeks. In general, it will take about a month before you’re back to all of your normal activities.
You should also avoid exposing the resulting scars to the sun for at least six months. Sunlight can permanently affect the skin’s pigmentation, causing the scar to turn dark. If sun exposure is unavoidable, use a strong sun block.