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Nipple Reduction Surgery

Having longer nipples than normal can either be caused by genetically being predisposed to them or also as a result of breastfeeding your children.  


The procedure of nipple reduction surgery is to shorten the length of the actual nipples.  This procedure can be done under local anesthesia or combined with other breast surgery. Shortening an overly long nipple will generally not interfere with breastfeeding; however there is still a risk that it might not be possible for some patients to perform.   

There are several methods used by surgeons for nipple reductions, including removal of just the top of the nipple, which is then closed with tiny incisions.  Another method is where the surgeon will remove a band of areola skin around the base of the nipple, and literally push the nipple back into the breast – in which it is then sutured into place. 



                               2010 Copyright Bland MD - Center for Plastic Surgery - Colorado Springs


The biggest risk with this procedure is losing the sensation in the nipple area and also contributing to not being able to breastfeed.  If this procedure is not done in conjunction with another surgery, this can easily be performed in the physician’s office with a local anesthetic.  Most patients have very little discomfort with this procedure. 



Swelling and pain for the most part are minimal, and the results are almost immediate.  The nipple takes on a much more natural appearance after the procedure and most patients will continue to have normal sensation. 




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Inverted Nipple Surgery 

Inverted nipples that project inward instead of outward, can affect breastfeeding as well as a patient’s confidence level.  The actual inverted nipple can take on an appearance of a slit or a depression in the actual areola itself. Inverted nipples are usually caused by shortened milk ducts. 


Most of the time an inverted nipple is a cosmetic problem; however it can also be a symptom of breast cancer, so you should always have this checked out.  Surgical correction of the inverted nipple transects the milk ducts and breast feeding after this operation may be impaired.



There are three different degrees of nipple inversion: 

  • Inverted Nipple Grade I – the inverted nipple is easily pulled out, and maintains it’s projection without traction.  Gentle finger pressure around the areola or pinching of the skin area will cause the nipple to pop back out.

  • Inverted Nipple Grade II – the inverted nipple can be pulled out, but not as easily as in Grade I.  After releasing traction, the nipple tends to fall back and invert again.

  • Inverted Nipple Grade III – in this grade, the nipple is severely retracted and inverted.  It is very difficult to physically force this nipple out and hold it there.



                                                 Inverted Nipples Before Surgery



                             Copyright 2010 MAYO Clinic Foundation - Used with permission




This procedure consists of a small incision at the base of the nipple while the nipple is in a protected projected state.  The surgeon then does a spreading of the fibers which are pulling the nipple inward.  This has to be done with much care as the spreading of these fibers parallel the milk ducts, in which all surgeons will go to great lengths to preserve.


Once the fibers are spread and the nipple is able to be freed from an inward position, special sutures are placed actually inside the nipple area to keep it from retracting back. 




The biggest risk to this procedure is trying to preserve the milk ducts so that breastfeeding will be possible.  Sometimes this is possible, and other complex cases sometimes the milk ducts will actually become detached.  Make sure you communicate with your surgeon what your goals are with breastfeeding in the future before committing to this surgery.









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